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Please use this form to register for
CLC Summer Camp
Please call us at 716-434-3196 if you have any questions. Thank you!
***Payment due with registration***
Pay Here
*
Indicates required field
Child's Name
*
First
Last
Age
*
DOB
*
Allergies/Medical Conditions
*
Please type "none" or "n/a" if there is nothing to share with us.
Camp Session
*
Intermediate Robotics: Grade 5+ (Aug 1-5 Morning session)
Astronomy camp: Grades 4+ (Aug 15-19 Morning session)
Aeronautics & Rocketry: Grades 5+ (Aug 15-19 Afternoon session)
Parent/Guardian Name
*
First
Last
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Parent/Guardian phone number
*
Parent/Guardian 2nd Phone Number
*
Emergency Contact Name
*
First
Last
Emergency Contact Phone Number
*
Comments?
*
Photography Consent
I give the Challenger Learning Center of Lockport permission to use my child's name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of CLC of Lockport activities. I agree that CLC of Lockport has complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the CLC of Lockport mission. These uses include, but are not limited to illustrations, bulletins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet.
Choose One
*
Yes, I give my permission.
No, I withhold permission.
Communications options
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Please add me to your mailing list to receive updates.
I am already on the list. Thank you!
Please do not add me to your mailing list.
How did you hear about us? Choose all that apply.
*
Friend/Family
Facebook
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Twitter
Lockport Union-Sun & Journal
WNY Family Magazine
Other
Send My Information
***Payment due with registration***
About Us
Calendar
What We Do
Challenger History
Our Crew
Employment
>
Summer Internship
Board of Directors
F.A.Q.
Gallery
Space Missions
Public Missions
School Missions
>
Field trip schedule
BOCES Forms
Virtual Missions
Calendar
Planetarium
Programs
Summer Camps
>
Summer camp registration
After School Programs
>
Registration
Birthday Parties
Extra Venue Activities (EVA's)
Scout Programs
STEM Resources
Support Our Mission
Donate
Become a Sponsor
Newsletter
Feedback
Membership
Volunteer