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Summer Program 2024
REGISTRATION FORM
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* Indicates required question
Name of child:
*
Your answer
Date of birth:
*
MM
/
DD
/
YYYY
Weeks of attendance (1-7):
*
1 week
2 weeks
3 weeks
4 weeks
5 weeks
6 weeks
7 weeks
Required
Daily duration
*
Full day (8am - 15:30pm)
Half day (8am - 11:30am)
Name of parent:
*
Your answer
Phone Number
*
Your answer
Emergency name and contact number:
*
Your answer
Email Address:
*
Your answer
Doe your child have any allergies
*
yes
no
Required
If so please list allergies:
Your answer
Please choose the following options
*
breakfast
snack
lunch
bus
Required
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