Build a Mini Bakery – Session 1 Registration

Summer Mini Bakery Camp Registration | July 13–17 | Session 1

Thank you for your interest in our Summer Mini Bakery Camp! Please fill out this registration form to help us prepare for a safe, fun, and engaging experience for your child. Make sure to complete all required sections.

Student Information

Student's Full Name:(Required)

First Last

Date of Birth:(Required)

Age at Time of Camp:(Required)

Grade Level (Ages 7–14):(Required)

School:(Required)

Parent / Guardian Information

Primary Parent/Guardian Name:(Required)

First Last

Relationship to Student:(Required)

Phone Number:(Required)

Email Address:(Required)

Secondary/Emergency Contact Name:(Required)

First Last

Emergency Contact Phone:(Required)

Staff will contact only in non-life-threatening situations.

Authorized Pick-Up

If different from parent/guardian.

Full Name:

First Last

Medical Information

This information helps us ensure your student's safety and comfort during camp. All details are kept confidential and shared only with camp staff as needed.

Allergies (food, environmental, other):

Please list all allergies and describe reactions (e.g., peanuts – anaphylaxis, seasonal pollen – mild).

Medical Conditions / Special Needs:

Include any conditions, diagnoses, or considerations we should be aware of (e.g., asthma, ADHD, anxiety, sensory needs).

Medications (Emergency Use Only):

Camp staff do not administer routine medications. We can support emergency or lifesaving medications only, such as inhalers or EpiPens. If your student requires an emergency medication during camp hours, please provide the details below: Medication Name: Dosage: When/Why Administered: Does your student self-carry?

Dietary Restrictions:

Please note dietary needs or restrictions (e.g., vegetarian, gluten-free, religious restrictions).

Emergency Medical Authorization(Required)

I understand that emergency services will be contacted when staff determine it is necessary for my student's safety.

I understand.

Photo & Media Release

Please let us know if your student can be photographed or recorded during camp activities.(Required)

I give permission for my student to be photographed or recorded during camp activities for promotional or educational use.

I do NOT give permission.

Liability & Participation Agreement

Date(Required)

Name(Required)

First Last

How Did You Hear About Our Camp?

This helps us improve how we reach families like yours!(Required)

Museum Website

Social Media (Facebook, Instagram, etc.)

Email Newsletter

Friend / Family Referral

Print (Bear Essentials, etc.)

Payment Information

Payment is collected separately, and your student's spot is not confirmed until payment is received. Please complete payment here: Pay Now

Submission of this form does not guarantee enrollment.

Your student's spot will be confirmed once payment is received. Please feel free to contact Michael Shea Muscarello at michaelm@theminitimemachine.org.

520-881-0606

info@theminitimemachine.org

Build a Mini Bakery – Session 1 Registration

Summer Mini Bakery Camp Registration | July 13–17 | Session 1

Student Information

Parent / Guardian Information

Authorized Pick-Up

Medical Information

Photo & Media Release

Liability & Participation Agreement

How Did You Hear About Our Camp?

Payment Information

Submission of this form does not guarantee enrollment.

The Mini Time Machine Museum of Miniatures