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First Coast Taekwondo - Summer Camp Reg 2020
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GENERAL INFORMATION
Child's Full Legal Name
*
Preferred Name
*
Child's Gender
*
Female
Male
Child's Date of Birth
*
MM
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DD
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YYYY
Elementary School Name
*
MEDICAL INFORMATION
Any Special Needs of Child?
Has child had any of the following:
*
Surgery
Serious Illness/Accident
Allergies
None of the above
If any of the above are checked please explain below.
Child's Swim Ability (select one):
If your child is a weak or non-swimmer, please provide your child with a
SWIM VEST on Pool Days.
*
Non-Swimmer
Weak Swimmer
Moderate Swimmer
Strong Swimmer
If there is anything else you would like to inform us about your child, please note below:
Ethnicity (This information is collected per request of the Kids Hope Alliance)
*
Please select
Hispanic or Latino
Not Hispanic or Latino
Prefer not to answer
Race: (This information is collected per request of the Kids Hope Alliance)
*
Please select
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
Does your child receive Free Lunch at your child's school? (This information is collected per request of the Kids Hope Alliance)
*
Please select
Yes, my child school provides free lunch to my child
Yes, my child school provides reduced lunch to my child
No, my child school does not provide free or reduced lunch to my child
Prefer not to answer
Do any household members currently participate in one or more of the following assistance programs: SNAP, TANF or FDPIR? (This information is collected per request of the Kids Hope Alliance)
*
Please select
Yes
No
Prefer not to answer
SUMMER CAMP: WEEKS ATTENDING
Please list your child's start date and end date for our Summer Camp program below. Also, for each Summer Camp week posted below, please mark whether your child will or will not be attending the applicable week. As a reminder, if your child is absent for an entire week, you must provide two weeks notice in writing (which includes this form). If two weeks notice is not provided, you will only be charged half tuition for that week.
• Summer Camp starts Monday, June 1st and ends Monday, August 10th
• Drop of Window: 7am to 9am, Students must arrive by 9am as our field trip departure starts at 9am
• Pick-up by 6:30pm
Summer Camp Start Date (Duval County's Last day of school is 5/29 & Clay County's Last Day of school is 6/3)
*
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Summer Camp End Date (Duval County's 1st Day of School is 8/10 & Clay County's 1st Day of School is 8/11)
*
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Days attending
*
Monday
Tuesday
Wednesday
Thursday
Friday
Summer Camp available weeks (select each week your child is attending)
*
June 1st - June 5th, 2020 (Clay County's Last Day of School is 6/5)
June 8th - June 12th, 2020
June 15th - June 19th, 2020
June 22nd - June 26th, 2020
June 29th - July 3rd, 2020 (closed July 3rd in observerance of 7/4)
July 6th - July 10th, 2020
July 13th - July 17th, 2020
July 20th - July 24th, 2020
July 27th - July 31st, 2020
August 3rd - August 7th, 2020
Monday, August 10th (Clay County Only- Duval County Starts school this day)
As a reminder, if your child is absent for an entire week, you must provide two weeks notice in writing (which includes this form). If two weeks notice is not provided, you will only be charged half tuition for that week.
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