DGMS Summer Camp Registration 2022
Please email info@dgmontessori.org if you have questions about summer camp activities, payment, what to bring, etc. We're excited to see you this summer!
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Email *
Child(ren)'s First and Last Name *
Child's Date of Birth (1st child) *
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Child's Date of Birth (2nd child)
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Child's Date of Birth (3rd child)
MM
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Child(ren)'s Gender *
Child(ren)'s Address (if different than parent / guardian)
Parent/Guardian First and Last Name *
Parent/Guardian Address *
Parent/Guardian Telephone *
Parent/Guardian Email Address *
Which week(s) will your child(ren) be attending camp? *
Required
Which program will your child be in? (1st child) *
Required
Which program will your child be in? (2nd child)
Which program will your child be in? (3rd child)
Full-day or half-day camp? *
Siblings' names and ages
Please list TWO additional emergency contacts who are authorized to pick-up your child(ren); include first and last name, relationship to the child, and phone number *
Does your child have any health conditions seen by a doctor? If yes, please explain. *
Does your child take any medication on a daily basis? If yes, please explain. *
Does your child have any allergies? *
List any special educational, physical, or emotional needs of your child, and acceptable accommodations for these needs. (DGMS stives to make reasonable accommodations within our facility and staff qualifications to serve students with disabilities and various needs.)
Please list current or previous schools, preschools or daycares attended (with name and dates of attendance): *
MEDIA RELEASE -- I grant full permission for my child's image to be used in photographs published to promote DGMS on public platforms such as the school website and social media. (Type your name as an electronic signature granting permission.)
VIRUS RELEASE -- By choosing to send my child(ren) to school, I accept all risk and responsibility should any member of my household become sick, and I release Discovery Garden Montessori School of any liability as such. (Type your name as an electronic signature confirming this statement. This is required.) *
Is there anything else that you would like us to know about your child?
Please type your name and date (this will act as your electronic signature) *
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