2024 Online Summer Camp Registration Form

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Program information: https://www.wellspringk12.org/summer

Please contact Mr. Pan at (628)280-8600 if you have any questions.

Email *

Program(s): which of the following weeks would you like to register? *

6/10 - 6/13 ($75/week, Monday to Thursday)

6/17 - 6/20 ($75/week, Monday to Thursday)

6/24 - 6/27 ($75/week, Monday to Thursday)

7/8 - 7/11 ($75/week, Monday to Thursday)

7/15 - 7/18 ($75/week, Monday to Thursday)

7/22 - 7/25 ($75/week, Monday to Thursday)

7/29 - 8/1 ($75/week, Monday to Thursday)

Required

Section: which of the following section would you like to register? *

Section A: 4 - 5 PM Pacific Time

Section B: 5 - 6 PM Pacific Time

Student's Name *

Student's Chinese Name (if any, optional)

Student's Date of Birth *

YYYY

Student's Age *

Student's Gender *

Student's Grade Level *

Address (Street, City, State, Zip code) *

Recording Release (in case you need to miss some class): *

I give permission for recording the live session.

I don't I give permission for recording the live session.

Acknowledgement *

Tuition can be refunded by June 3rd. After June 3rd, tuition is not refundable, as we have limited space and do not want any space wasted. We will only have recordings if all the registered students are present in that class. If your children miss that class, you will be emailed with a link to the video.

Required

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