Salam Central School’s Out Summer Camp (2025)

Please fill out one form per child. Each participant will be contacted after their form is filled regarding consent.

Name of Participant

First Name

Last Name

Birthdate

MM

DD

YYYY

Grade

Enter the grade they will be joining in September.

Gender

Parent/Guardian Information

Parent/Guardian Name

First Name

Last Name

Home

(###)

###

####

Cell

(###)

###

####

Email

Camp Dates

Please select all the weeks you're interested in.

Week 1: July 7th - 11th

Week 2: July 14th - 18th

Week 3: July 21st - 25th