AQUA 101 Summer Day Camp Online Registration Form

Participants must be age 9-13.

Form fields with * are required to register.
Please contact us if you have any questions.

Program Information

Mondays-Fridays 10AM - 4PM

Student Information

Month / Day / Year

Example: 718-555-1212

Email is the primary means of communication throughout the program. Be sure you check the email address you provide to us frequently. If you do not have regular internet access, please let us know and we will work to accommodate you.

Parent Emergency Contact

Additional Emergency Contact

About You

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