Education in Nature

Jul 2 - Jul 6 2019

Registration

Who are you?

I am a parent or guardian - registering my child to attend this program!

I am a prospective student - registering myself to attend this program!

History at Kroka:

This student will be coming to Kroka for the first time!

This student has registered for another Kroka program within the past 12 months.

This student has attended a previous Kroka program some time ago.

Student Contact Information



(Optional, please don't enter parent's number here...)

(Student's email address goes here,
parent information comes later!)

Biographical / Medical Information

Male Female

 

PLEASE WRITE A FEW SENTENCES FOR US ABOUT this student:

PLEASE DESCRIBE ANY CONCERNS THAT WE SHOULD BE AWARE OF:

Parent or Emergency Contact Information #1

check here if same as student address



Parent or Emergency Contact Information #2

check here if same as student address



Inspiration!
What inspired you to register for this program?
I/We have participated in Kroka before
Someone (a personal friend or teacher) recommended Kroka to us
I/We found you online!
I/We read the Kroka brochure, or saw a poster or print advertisement
I/We heard about Kroka at school, or on a school-sponsored Kroka trip
I/We personally met a Kroka staff member or program participants at a special event or out in the wilderness!
A mysterious force has led me here. I cannot explain it!
Confirm
Have you read our Parent Student Handbook?
By checking here I confirm that I have read the parent student handbook.
Please check this box:
Sorry robots!
Our programs are not intended for you.