Waiting-list Application for 2024 Summer Camp Registration at Pilot Park Preschool

ALL SPOTS ARE CURRENTLY FULL FOR BOTH SUMMER CAMPS SESSIONS. PLEASE FILL OUT THIS APPLICATION TO GET ON OUR WAITLIST.  

Pilot Park Preschool is an in-home nature-based program that runs 9-3pm Tuesday through Thursday in the summer during the months of June and July. Extended day is available from 8:30-3:30pm.

June - DINOSAURS & FOSSILS (June 4-6, 11-13, 18-20 and 25-27)

July - FAIRIES, GNOMES & EVERYTHING MAGICAL (July 9-11, 16-18, 23-25 and 30-31)

*Payment of registration fee needs to be included to complete the application process. Registration is a payment-reserved basis - we are unable to guarantee a particular schedule until the registration fee is received.

Please indicate which days you are enrolling your child in. Child must be potty trained by the first day of class.

REGISTRATION FEE is $20.00 per student per session. The registration fee covers all supplies and holds your child’s spot. You will be contacted to setup this payment once this registration form is received and availability is confirmed. This fee is non-refundable.

Tuition is due on the 2nd of each month of June and July. Tuition will not be refunded for holidays, illness, school closings mandated by state or local authorities, personal and/or vacation time.

Pilot Park Preschool does not discriminate in regards to race, sex, religion, national origin, disability or political belief. 

Sign in to Google to save your progress. Learn more
Email *
Child's Name *
Birth date *
MM
/
DD
/
YYYY
Gender *
Address *
Does your child have any allergies or take any medication?
 *
Is your child potty trained? *
Parent/Guardian #1
 *
Work/Cell # *
Email *
Occupation *
Place of employment *
Parent/Guardian #2
Work/Cell #
Email
Occupation
Place of employment
Marital status of parents *
Child lives with *
If my first choice is not available, please enroll my child in my second choice. I understand we will be placed on a waiting list for our first choice and notified if space becomes available. (Please indicate first & second choice.)
 *
First choice for June (4th-27th) - DINOSAURS & FOSSILS *
Second choice for June (4th-27th) - DINOSAURS & FOSSILS *
First choice for July (9th-31st) - FAIRIES, GNOMES & EVERYTHING MAGICAL *
Second choice for July (9th-31st) -  FAIRIES, GNOMES & EVERYTHING MAGICAL *
Regular preschool hours are 9-3pm. Would you like extended day (8:30-3:30pm)? Extended day is available for an extra $20/month per day.

Tues/Thurs   $40/month more
Tues/Wed/Thurs   $60/month more
 *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms