Summer Camp Enrollment

Leap Ahead Preschool

Summer Camp 2024 Enrollment Form - 1st day of summer camp is Tuesday, May 28th!

Parent 1 details
Parent 1 name*

First NameLast Name
Parent 1 email*
example@example.com
Parent 1 primary contact phone*
Please enter a valid phone number.
Parent 1 secondary contact phone
Please enter a valid phone number.
Parent 1 address (if not same as child's address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 1 employment

Parent 2 details
Parent 2 name

First NameLast Name
Parent 2 email
example@example.com
Parent 2 primary contact phone
Please enter a valid phone number.
Parent 2 secondary contact phone
Please enter a valid phone number.
Parent 2 address (if not same as child's address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2 employment

Questions
Any other information you want us to know?
Optional - Please list anything specific you want us to know about your child that will help them have a great summer camp experience.

Emergency contact details
Emergency contact 1*

First NameLast Name
Emergency contact 1 is authorized for:*

Emergency ContactStudent Release (Pickup)
Emergency contact 1 phone number*
Please enter a valid phone number.
Emergency contact 2*

First NameLast Name
Emergency contact 2 is authorized for:*

Emergency ContactStudent Release (Pickup)
Emergency contact 2 phone number*
Please enter a valid phone number.
Emergency contact 3

First NameLast Name
Emergency contact 3 is authorized for:

Emergency ContactStudent Release (Pickup)
Emergency contact 3 phone number
Please enter a valid phone number.
In the event of a medical emergency, I give permission to Leap Ahead Preschool to authorize medical treatment of my student in the event that I can not be reached.*

YesNo
Is s/he allergic to anything?*
Is s/he taking any medication regularly?*
Anything else we should know?
Doctors Name, Office Phone number and Address*

Additional approvals
May we apply sunscreen to your student?*

Yes - Leap Ahead Preschool may apply sunscreenNo - Leap Ahead Preschool may NOT apply sunscreen
How may we use photos of your student?*

Yes - Leap Ahead Preschool can use solo AND group pictures of my student on Facebook, website and presentationsYes - Leap Ahead Preschool can use group pictures ONLY (no solo pictures) of my student on Facebook, website and presentationsNo use - Leap Ahead Preschool can not use solo OR group pictures of student

Signature
Notice

Leap Ahead Preschool retains the right to dismiss from the group any child who demonstrates an inability to participate in or benefit from the school, or whose presence is detrimental to the group.
Summer Camp Behavior Contract

Summer camp is an exciting program we offer at Leap Ahead, and we want to be sure we are offering a high-quality and safe program. A high-quality program can only take place in an orderly, mutually respectful, caring environment. At Leap Ahead we take the happiness and safety of our participants seriously. Therefore, we work very hard at creating a safe and fun environment. Along with our efforts, we need the children and parents to help us by following some simple rules. Due to the nature of this program children must be able to follow instructions and rules to be safe. Below is our behavior agreement.

Please read this Behavior Contract with your child and ensure they understand our camp’s behavior policies.
- I will listen to the teachers and follow directions.
- I will respect other people’s personal space by keeping my hands and feet to myself.
- I will respect other people’s feelings by having a positive attitude when talking to them.
- I will act in a caring way, and I will not hit, fight, bite, tease, harass or bully others.
- I will use appropriate language, which does not include swear words or negative remarks (i.e. “shut up”, “stupid,” “dumb.”)
- I will not call other children names.
- I will use my words to solve my problems.
- I will respect the school’s materials and use them appropriately (i.e. not smashing and breaking toys.)
- Parents who enter the center will not correct, put down or talk to other children in any way that is upsetting to the child. Parents understand if there is an issue with another child, they will report the issue to teachers and leave the directing to the teachers.
- Not abiding by these rules may result in suspension and/or removal from the program.
- Incidents will be handled on a 3-incident system, EXCEPT hitting, kicking, biting, fighting, bullying, and inappropriately touching another camper.
- When an incident occurs, the child may be asked to sit in a chair or go to the office to talk about the incident.
- Hitting, kicking, biting, fighting, bullying and inappropriately touching another camper may result in immediate 1-3 day suspension from the program. All other incidents will be handled as follows:
  - 1st Incident = Verbal Warning
  - 2nd Incident = Emailed incident report & Parent Contact (parents will be talked to by phone or in person.)
  - 3rd Incident = 1 to 3 day suspension & Parent Meeting with Mrs. Shanda
- More than 3 incidents will be subject to camper dismissal from the program.
  Leap Ahead staff reserve the right to dismiss/dis-enroll a child from the summer camp if the child’s behavior is disruptive to the program and/or compromises the safety of themselves, other children and/or staff.
- Children suspended or terminated from the program will receive a refund for any unused camp days.
- Children who attend part of a camp day and are sent home will pay full rate for that day.
By signing, I agree to partner with Leap Ahead in making my child’s summer camp experience positive and safe for all children and families involved.
Do you agree to abide by this Leap Ahead Summer Camp Behavior Contract?*

YesNo
Signature*

Clear
Please sign your full name in this box to indicate you have, to the best of your knowledge, accurately and completely filled out this application form.
Signed date*

MonthDayYear
Date
Hour MinutesAM/PM Option
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Leap Ahead Preschool

Notice