2022 EKS Piano Summer Camp Registration (For Current and Former EKS Students ONLY)

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Age: 5-16 (Including complete beginners)

Date: July 11-15, 2022 (5-day Program)

Time: 9a.m.-4p.m. (Full Day); 9a.m.-noon (Half Day)
Early and After Camp Childcare available

Venue: Eastern Nazareth College

Tuition: $525 (Full Day) / $375 (Half Day)
Early Bird [Before March 15, 2022]: $475 (Full Day) / $340 (Half Day)
Sibling Discount : 10% off each additional siblings
Early-hour Childcare 8-9a.m. $12/day
After-hour Childcare 4-5p.m. $12/day (Not available for half-day campers)

A non-refundable $75 deposit will be charged to your credit card on file to hold your spot upon registration. Full remaining balance must be submitted on or before May 26 or we will charge the remaining balance to your credit card on file on May 27. Full payment required for any late registration after May 26. There will be no refund after June 4, 2022.

Student First Name *

Student Last Name *

Is the student a current EKS student? *

Yes, I am an existing student

No (Please use the other Registration form if you are a new student)

I am a former student

Gender *

Male

Female

Prefer not to say

Required

Age *

Birthday *

YYYY

Address *

Home Phone No:(e.g. 617-111-2222) *

Parent Name: *

Parent Email Address (e.g. eksparent@test.com) *

Parent Cell Phone No: (e.g. 617-111-2222) *

Parent Address (if different from student)

Emergency Contact Person (Please listed relationship with student), e.g. John Smith, father *

Emergency Contact Person Phone Number: *

Full-Day or Half-Day *

Full Day (9a.m.-4p.m.)

Half Day (9a.m.-noon)

Required

Early-Hour Childcare, 8-9a.m.

Monday (7/11)

Tuesday (7/12)

Wednesday (7/13)

Thursday (7/14)

Friday (7/15)

After-hour Childcare, 4-5p.m. (Friday 7/15 not available)

Monday (7/11)

Tuesday (7/12)

Wednesday (7/13)

Thursday (7/14)

Allergy (Please list all allergies) *

Please check ALL the boxes below: *

I understand that a non-refundable $75 deposit will be charged to my credit card on file to hold my spot upon registration. I will submit the remaining balance in FULL on or before May 26 or EKS will charge the remaining balance on my credit card on file on May 27. I also understand that there will not be any refund after June 4, 2022.

I am responsible for the drop off and pick up of my child to and from the camp.

I am fully aware the camp is a peanut-free environment. My children will not bring in any peanut-related food to the camp.

My children is fully vaccinated. If not, my children will wear a mask all day during the ENTIRE camp duration except during snack and lunch sessions.

Required

Payment Preference: *

Please send me an invoice and charge my remaining balance on my credit card on file right away.

Please send me an invoice and charge my remaining balance on my credit card on file on 5/27/2022.

Please send me an invoice and I will bring in a check before the due date.

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