Summer Program Enrollment Form

The time is drawing near where we need to start planning for summer. Our summer camp program will be 6 weeks, starting July 8th and ending August 16th. Each week will be a different theme and programs will be limited in enrollment. The camp day will begin at 8:00am and will end at 3:00pm. 

We will be offering Am and Pm Care. 

Am care will be from 7am – 8am @ $40.00 per week in addition to weekly camp rate. 

Pm care will be from 3pm – 5pm and billed accordingly; 3:00-4:30-$65.00 per week 3:00-5:00- $80.00 per week. This fee is in addition to weekly camp rate. 

The cost of camp is $280.00 per week; (non-refundable) this will include all camp supplies. Payment is due June 17th for all weeks you are attending in July and payment is due July 26th and all weeks you are attending in August. 

There is a 10% discount for the second child 

There will be a $75.00 one-time Registration fee which will be (non- refundable) per family. 

This charge is to hold your spot for the summer program. 

Space is LIMITED per week!! 

Each day your child (ren) will be asked to bring a water bottle, full lunch and 2 snacks 

for morning and afternoon.

We will also be serving hot lunch this summer due to high demand.

Wednesday with Kona Ice in the afternoon. 

Thursdays will be Water fun day 

Fridays we will be having Amazing Athletes providing us with multi-sports and fitness programs.

 Thank you, as always for sharing your children with Mother Teresa Academy! 

Please complete this form for each child you'd like to sign up. 


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Please select the weeks you would like to sign your child up for.  *
Here is some more information regarding the dates and themes for each week. 

Week 1:    ***CLOSED FOR REGISTRATION***

Week 2:    July 15th – July 19th            Bug Week

Week 3:    July 22nd – July 26th            Reptile/Dinosaur

Week 4:    July 29th – August 2nd        Camping Week

Week 5:    August 5th – August 9th        Beach Week

Week 6:    August 12th – August 16th        Science Week
Required
Parent's First Name *
Parent's Last Name *
Email Address *
Child's First and Last Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Grade *
Full Home Address *
Mother's Cell Phone Number  *
Father's Cell Phone Number *
Name and Relationship of Primary Emergency Contact *
If we can't get ahold of a parent, who should we call?
Primary Emergency Contact Cell Phone Number *
Name and Relationship of Secondary Emergency Contact
Secondary Emergency Contact Number
Will Your Child Require AM Care? *
Will Your Child Require PM Care? *
4:30 or 5:00 PM
If Your Child Will Require PM Care, What Time Will They Require It Until?
Please select either 4:30 or 5:00
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