Complete all sections of this form to register your child/children for the summer program.  
-General Information
-Photo/Video Release
-Medical Information
-Parent Contact Information
-Alternative Contact Information
-Approved Contacts for Pick Up

Please fill out one form for your family. Please type N/A if an answer is not applicable but is required.  
All phone numbers must be entered in this format, ###-###-####.  

Program Details:
The program cost for each week is $150/week.  
Program hours are 8:00am to 3:15pm, Mondays and Wednesdays.  Rain or Shine.


Activities each day include:
Devotions & Bible Study
Arts & Theater
Reading & Math Practice
Science Experiments & Nature Study
Board Games & Social time
Splash games outside
Sports/Dance/Movement

Snacks and lunch must be provided by family.

Please notify us of any changes in information.  Also, please save a copy of your submission for your records and in case of a technology mishap.