Summer Camp Registration – Test Once we have received the registration for your child, we will send a more detailed form for your completion which will include emergency contacts, medical information etc. Student First Name* Student Last Name* Student Age* Entering Grade in Fall 2022* Where did you hear about Summer at Athena?* Parent Contact InformationParent First Name* Parent Last Name* Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Parent Email Contact* Enter Email Confirm Email Parent Phone Number*Early Bird Registration Price: Early bird registration good through March 15, 2022Payment MethodCredit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name EmailThis field is for validation purposes and should be left unchanged.
