College for Kids Registration

Welcome!

Please submit one form per child.

For more information about the camps offered and general questions, email community.education@llcc.edu or call 217-786-2432 before submitting this form.

Student's Info

Student's Legal First Name

Student's Legal Last Name

Student's Birthday

MM/DD/YYYY

Street Address

City

State

Abbreviation (ex: IL)

Zip

To enable us to best serve your child, please list any food allergies, medical or learning needs

Select the grade the student is entering for the 2025 school year.

Primary Adult Information

First Name

Last Name

Primary Phone Number

Primary Email

Alternate Adult Information

First Name

Last Name

Alternate Phone Number

Alternate Email

How did you hear about us?

Under 16 Pick Up

Children under the age of 16 will only be released to persons authorized by the parents/guardians on this form.

List First and Last Names here for pick up:

Camps

Use the boxes below to select the camps. You may select multiple camps. Please be aware of the camp dates and times in order to avoid selecting camps that overlap with each other.

Camps are arranged by grade groupings: 1st-3rd, 4th-6th, 6th-8th, 7th-10th Workforce Career Exploration, and 5th-8th Culinary.

Grades 1-3

Camp Fee: $149 per student

June 9-12 (Grade 1-3)

How Does Your Garden Grow? | 9am-12pm (YES-700-001)Fairy Flips and Fancy Twists | 9am-12pm (YES-700-003)Yoga and Mindfulness | 1-4pm (YES-700-008)

June 16-19 (Grade 1-3)

Dino Diggers | 9am-12pm (YES-700-013)Lights, Laughter, Action: Theater for Young Stars | 1-4pm (YES-700-021)

July 7-10 (Grade 1-3)

Roots of Calm and Strength: Martial Arts | 1-4pm (YES-700-040)

July 21-24 (Grade 1-3)

American Sign Language | 9am-12pm (YES-700-053)

Grades 2-5

Camp Fee: $149 per student

June 16-19 (Grade 2-5)

Illinois Symphony Youth Orchestra Camp | 9am-12pm (YES-700-014)Illinois Symphony Youth Orchestra Camp | 1-4pm (YES-700-023)

Culinary (Grades 5-8)

Fee: $195 per student

June 9-12

Make, Bake, & Donate | 9am-12p.m (YES-701-001)Pizza Party Week | 9am-12p.m (YES-701-002)

June 16-19

Pastry Arts | 9am-12p.m (YES-701-003)So You Want To Be a Chef? | 9am-12p.m (YES-701-004)

July 14-17

Cookie Week | 9am-12p.m (YES-701-005)Make a Meal | 9am-12p.m (YES-701-006)

July 21-24

Around the World | 9am-12p.m (YES-701-009)So You Want To Be a Baker? | 9am-12p.m (YES-701-008)

Workforce Career Exploration (Grades 7-10)

Fee: $195 per student, unless otherwise indicated.

June 9-12 Workforce (Grades 7-10):

Girls in Construction | 9am-12pm ($25) (YES-700-007)

June 23-26 Workforce (Grades 7-10):

Summer Sparks: Welding Camp | 9am-12pm (YES-700-031)

July 7-10 Workforce (Grades 7-10):

Sheet Metal 101 | 9am-12pm (YES-700-038)

July 14-17 Workforce (Grades 7-10):

Watt's Up Electricians? | 9am-12pm (YES-700-047)

Jacksonville Camps (Location: LLCC Jacksonville Campus)

Fee: $149 per person unless indicated

*These camps are held at our Jacksonville Campus

*The culinary camp is held at Illinois School for the Deaf (125 S Webster Ave, Jacksonville, IL)

June 9-12 (Grade 1-3)

Camp Namaste (Jacksonville) | 9am-12pm (YES-700-002)

July 14-17 (Grade 1-3)

American Sign Language (Jacksonville) | 9am-12pm (YES-700-046)

June 9-12 (Grade 4-6)

Camp Namaste (Jacksonville) | 1-4pm (YES-700-011)

June 16-19 (Grade 4-6)

Theater Adventures (Jacksonville) | 9am-12pm (YES-700-015)

June 23-26 (Grade 4-6)

Web Wizards (Jacksonville) | 9am-12pm (YES-700-026)

June 23-26 (Grade 6-8)

Math Magicians (Jacksonville) | 1-4pm (YES-700-035)

July 21-24 (Grade 4-6)

American Sign Language (Jacksonville) | 1-4pm (YES-700-048)

July 21-24 Culinary (Grade 5-8)

Brunch Basics (off site) | 9am-12p.m ($195) (YES-700-007)

Total Cost

Waiver and Agreement

Waiver Agreement

Please read and agree to each of the statements below by checking the box next to each statement.

By execution of this form, I agree that all requirements, directions and standards set by staff, use of any equipment or supplies under the supervision of the staff, shall be deemed to have been accomplished for the benefit of my child. In the consideration of Lincoln Land Community College’s efforts on my child’s behalf, I do hereby voluntarily assume all risk of accident, injury, damage and/or loss to my child’s property that may arise out of my child’s participation in College For Kids, hereby intending to release and discharge Lincoln Land Community College, its Board of Trustees, officers, employees and agents associated or connected with College For Kids from every claim, liability or damage of any kind caused by negligence of Lincoln Land Community College, its Board of Trustees, officers, employees or agents involved or otherwise that may result from my child’s participation in College For Kids.

Checking the box below acknowledges that the child named is a minor under the age of 18. Although a minor, my child is aware of the risks involved with participating in College For Kids. I assure Lincoln Land Community College that I have carefully counseled my child on the risk of participating. Further, I assure Lincoln Land Community College that there are no physical or other reasons that preclude my child from participating in College For Kids. I authorize Lincoln Land Community College to obtain such medical care, emergency or otherwise, that it may in its sole discretion deem necessary for my child. Further, I assure Lincoln Land Community College that I have adequate health insurance or personal funds to provide payment for all costs of medical care necessary for my child. I agree to indemnify and hold harmless Lincoln Land Community College for any costs associated with such care.

College For Kids staff reserves the right to dismiss students from classes for disciplinary reasons. All students are expected to behave in a positive and productive manner. Parents will be notified if inappropriate behavior is observed and documented. Should behavior continue, students will be dismissed from the program. No refunds will be given.

Please select one:

Allow this student to be used in promotional materialDo not allowFor promotional use only. Name and identity remain anonymous.

What happens now?

We will call you within 3 business days to collect payment.

Please keep an eye out for our call. If we are unable to reach you, we will leave you a voicemail. If we dont hear from you, we will be forced to cancel your registration request, and you will need to complete and submit a new form to register.

I understand my registration is not complete until payment has been made.