Break on the Avenue Thanksgiving Camp Registration

Student information

Tell us about the student registering.

Parent / guardian contact

Parent/guardian name *

Contact email *

Phone number 1 *

Phone number 2

Camp days

$40 per day, 7:30 AM–3:30 PM. Choose the days your student will attend.

Monday, November 23Tuesday, November 24Wednesday, November 25

Camp total: $0 (0 days × $40)

I'm interested in optional after care until 6:00 PM ($10 per hour, billed with the payment link).

Requirements & payment

My student will have their own transportation to and from camp. *I understand no payment is taken now. If my student is accepted, a payment link will be sent with the acceptance email. *

Allergies, medical needs or anything we should know (optional)

Demographics (optional)

Used only for our impact report, in grouped totals. Skip any question or choose “Prefer not to answer.”

Gender identity

Home ZIP code

People in household

Household income range

Break on the Avenue Registration

Student information

Parent / guardian contact

Camp days

Requirements & payment

Demographics (optional)