EmailMe Form - Summer Camp 2017 Registration

Student's Name *
First Last
Date of Birth *
Sex
Male
Female
School Attending
Grade in the Fall *
Parent or Guardian Name *
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Home Phone *
### - ### - ####
Alternative Phone
### - ### - ####
Emergency Contact Name (Other than Parent listed above) *
First Last
Relationship
Emergency Contact Phone *
### - ### - ####
Additional Contact
Phone
### - ### - ####
Please Note:
By signing this agreement, I agree to hold harmless The Children’s School for any damages or liabilities arising out of or in connection with my student’s enrollment at The Children's School Summer Camp. I give permission for the student named above to take part in all summer camp activities. In the event of illness or accident to the student and the above people cannot be reached, school personnel is authorized to provide first aid, transport the student to any hospital and to authorize emergency medical or dental care by a duly licensed physician or dentist, and hospital care.
Signature of Parent or Guardian *
Clear
Allergies, injuries, operations, restrictions on physical activity, or anything else we should know about your child: *
2017 Summer Camps
June 19 - 30
9:00 a.m. - 3:00 p.m.
Summer Ballet Intensive Level I for ages 9 -12 ($700)
Summer Ballet Intensive II for ages 12 - 18 ($700)
July 3 - 7
(No Camp July 4)
9:00 a.m. - 12:00 p.m.
Summer Fun Dance July 3 - 7 for K-4th ($165)
July 3 - 14
(No Camp July 4)
9:00 a.m. - 12:00 p.m.
Summer Fun Dance for K-4th ($350)
July 10 - 14
9:00 a.m. - 12:00 p.m.
Summer Fun Dance for K - 4th ($195)
Minecraft @ TCS for 1st-5th ($200)
July 10 - 14
12:30 - 3:30 p.m.
Mad Science Crazy Chem-Works for 1st - 5th - CLOSED
July 17 - 21
9:00 a.m. - 12:00 p.m.
Dancing Princesses for PreKindergarten-3rd ($195)
Video Game Making with Scratch - CLOSED
July 24 - 28
9:00 a.m. - 12:00 p.m.
Mickey Mouse Club for K-4th - CLOSED
Minecraft @ TCS for 1st - 5th ($200)
July 24 - 28
12:30 - 3:30 p.m.
Mad Science Adventures in the Wild for 1st-5th - CLOSED

2017 Summer Camps