Valencia Park 2021 Summer Registration
PLEASE NOTE:
OUR VALENCIA PARK SUMMER PROGRAM IS FULL. UPON COMPLETING THIS FORM, YOU WILL BE PLACED ON THE WAIT LIST.

Please complete this form to register your child for our 2021 Summer Program after completing the orientation video.

If you have not watched the orientation video, please follow the link below and make sure to note the orientation code given during the video.



https://www.youtube.com/watch?v=2W0dFFsZLPs 



SUMMER OPERATION DATES: Tuesday, June 1st- Friday, August 6th

HOURS:  7am-6pm Monday through Friday

COST:

Registration $20 for 1st child OR $30 for 2 or more children

Full Day (7am-6pm): $40/week for 1st child $35/week for 2nd child
Half Day (12pm-6pm): $25/week for 1st child $20/week for 2nd child

PLEASE NOTE:
OUR VALENCIA PARK SUMMER PROGRAM IS FULL. UPON COMPLETING THIS FORM, YOU WILL BE PLACED ON THE WAIT LIST.


Please read and initial below:
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Email *
ORIENTATION CODE (Please watch video before completing the registration form) *
Will your child attend our full day or half day program? *
First Name (Child 1) *
Last Name (Child 1) *
Gender (Child 1) *
Birth Date (Child 1) *
MM
/
DD
/
YYYY
Grade (2021-2022 School Year) *
T Shirt Size (Please order a size up if you are unsure, you will not be able to exchange sizes) *
Race/Ethnicity *
If your child has an accommodation plan with their school please state (IEP, 504 Plan, etc.)
Allergies (Child 1) *
Permission for Doctor/Hospital in the event of an emergency *
Media Permission *
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