2024 Manice Education Center: Returning Camper Registration Form

Christodora's 2024 Manice Education Center Program is open to middle and high school students who are residents of New York City.

Program Information

Program Year

2024

Applicant Type

Returning

Program Term

Summer

Returning Camper Info:

Student First Name

Student Last Name

Age

Birthdate

Gender (Check One)

FemaleMaleOther

School Name

Current Grade (2023-24)

Partnering Program Name

Camper's Email

Camper Cell Phone

Home Address

Home Address

City

State

Zip Code

Optional:

You most identify with (check all that apply):

African American/Black (including Africa & Caribbean)Hispanic/Latino (including Spain)White (including Middle Eastern)Asian (including Indian subcontinent & Philippines)Native American (including all Original Peoples of the Americas, HI, or AK)

Please answer the following questions:

Do you have any other summer plans that might cause a scheduling conflict with the session that you're interested in? (For example: summer school, summer job, family vacation, etc.? ) Do you have any academic enrichment programs this summer? (For example: high school placement programs, regents, etc.)

What are you looking forward to this summer at Manice?

What, if anything, worries you about attending summer camp?

PRIMARY Guardian/Parent Info. Guardian/Parent must provide e-mail, phone number, or both:

Primary Legal Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Home Phone

Parent/Guardian Cell Phone

Parent/Guardian Work Phone

Language(s) Spoken by Parent/Guardian

SECONDARY Guardian/Parent Info

Secondary Legal Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Home Phone

Parent/Guardian Cell Phone

Parent/Guardian Work Phone

Language(s) Spoken by Parent/Guardian

Please review your application before submitting your form. If you have any issues submitting the form please contact the Admissions Team: admissions@christodora.org or (347)-468-2878.

Contact Information