AJJCS Summer School/Camp Registration Form
AJJCS is offering FREE School School/Camp for the 2023-24 School Year!

Please complete this registration form to enroll your child(ren) in the program.

The program will run Monday to Friday, 8:30 AM to 4:30 PM, for three weeks, July 10-28, 2023.  

Please complete this registration form by June 15, 2023. 
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Email *
Child Name (First Name and Last Name)
 *
Child's Grade for 2023-24 School Year
 *
Second Child Name (First Name and Last Name)
Second Child's Grade for 2023-24 School Year
Clear selection
Third Child Name (First Name and Last Name)
Third Child's Grade for 2023-24 School Year
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Fourth Child Name (First Name and Last Name)
Fourth Child's Grade for 2023-24 School Year
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Home Address (Street Address, City, Zip Code)
 *
Home Phone/Cell Phone
 *
Emergency Contact (Name and Phone Number)
 *
Please indicate if your child has a medical issue or allergy
For staffing and planning purposes, please indicate when your child(ren) will attend? 
We would LOVE to have our students EVERY DAY!!
Monday
Tuesday
Wednesday
Thursday
Friday
July 10-14, 2023
July 17-21, 2023
July 24-28, 2023
What activities would you like to see offered in our summer school program? If your child(ren) went to Summer School last year, what were their favorite activities?
Please list any questions or comments about Summer School/Camp if you have any.
Parent Name *
Phone Number *
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