Summer at Saint Mark's Preschool Summer Program
Preschool Summer Program Registration & Enrollment Contract. (Please note: students entering DK in the fall should attend the Preschool Summer Program). Please click here to review the waiver information. You will need to sign at the end of the document acknowledging you have read the waiver. 
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Child's Full Name *
Child's Gender *
Child's Date of Birth *
Are you currently enrolled at Saint Mark's? (Please note that preference will be given to currently enrolled Saint Mark's students.) *
Required
If you are not currently enrolled at Saint Mark's, what school do you go to?
Child's Grade in the Fall *
Child's Address *
Camp Choice *
Required
*
Half Day (8:30AM-12:30PM)
Full Day (8:30AM-3:30PM)
Full Summer (Sessions 1 and 2)
Parent 1/Guardian 1 (Full Name, Address, Place of Employment, Email, Cell phone & work phone #) *
Parent 2/Guardian 2 (Full Name, Address, Place of Employment, Email, Cell phone & work phone #)
Financial Responsibility - Name
Insurance Company name, group and member #:
Family Physician Phone # and Address *
In addition to the parents, the following persons may be called in an emergency and/or are authorized to take the child(ren) from the facility. Completion of the following section is required. Please list in calling order:
In case of earthquakes or other disasters, please list an out-of-state contact name and phone number:
If you work outside of the home, how many miles from camp do you work (Father, mother)?
Please list the following information. Please write "N/A' if none of the below apply:
1. Last Tetanus (DTP) Booster (MM/DD/YY Required)
2. Allergies - Foods, environmental, medications, etc.
3. Medications - List all including those taken only at home.
4. Restrictions - Physical, Medical, etc.
One camp t-shirt is provided to each camper. Extra shirts may be purchased for $10 each (payment is due with camp registration - while supplies last). Campers must wear their shirts for any on-campus presentations or other specified days. 
Please indicate the camper's name, shirt size and quantity desired. Sizes include: YS(4-6), YM(7-8), YL(10-12), YXL(14-16).
By signing below, you acknowledge that you have read the linked Summer Camp Waiver (linked in the above description), and that you agree and consent to the student listed above participating in all summer program activities ("Activities") unless Parents provide the School's Business Office written notice to the contrary. 

Parent Signature #1, Parent Signature #2, and Date
 *
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