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ALPH - PFLC - Camps - 2022-23 School Break Camp Registration
Thank you for choosing Camps at Phase! Please fill out this form to register for one of our school break camps.
7
Questions
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1
Has your student attended a program at Phase Family Learning Center since August 1st, 2022
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This field is required.
No
Yes
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2
Student Information
*
This field is required.
Student First and Last Name
Student Date of Birth (MM/DD/YYYY)
Please Select
Yes, add another student.
No, only register one student.
Please Select
Please Select
Yes, add another student.
No, only register one student.
Would you like to register an additional student?
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3
Student 2 Information
Student 2 First and Last Name
Student 2 Date of Birth (MM/DD/YYYY)
Please Select
Yes, add another student.
No, that's all.
Please Select
Please Select
Yes, add another student.
No, that's all.
Would you like to register an additional student?
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4
Student 3 Information
Student 3 First and Last Name
Student 3 Date of Birth (MM/DD/YYYY)
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5
Parent/Guardian Information
*
This field is required.
Parent/Guardian First and Last Name
Parent/Guardian Email Address
Parent/Guardian Contact Phone
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6
Select Camp Enrollment Dates
*
This field is required.
Please select all dates for which you would like to enroll your student.
February 20 - Presidents' Day
February 21 - Professional Development Day
February 20-24 - ICS Break
March 13 - Professional Development Day
March 14 - Teacher Work Day
April 3 - Spring Break (Single Day)
April 4 - Spring Break (Single Day)
April 5 - Spring Break (Single Day)
April 6 - Spring Break (Single Day)
April 7 - Spring Break (Single Day)
April 3-7 - Spring Break (Full Week)
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7
Student 2 Enrollment Calculation
Please select all dates for which you would like to enroll your student.
February 20 - Presidents' Day
February 21 - Professional Development Day
February 20-24 - ICS Break (Full Week)
March 13 - Professional Development Day
March 14 - Teacher Work Day
April 3 - Spring Break (Single Day)
April 4 - Spring Break (Single Day)
April 5 - Spring Break (Single Day)
April 6 - Spring Break (Single Day)
April 7 - Spring Break (Single Day)
April 3-7 - Spring Break (Full Week)
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8
Student 3 Enrollment Calculation
Please select all dates for which you would like to enroll your student.
February 20 - Presidents' Day
February 21 - Professional Development Day
February 20-24 - ICS Break
March 13 - Professional Development Day
March 14 - Teacher Work Day
April 3 - Spring Break (Single Day)
April 4 - Spring Break (Single Day)
April 5 - Spring Break (Single Day)
April 6 - Spring Break (Single Day)
April 7 - Spring Break (Single Day)
April 3-7 - Spring Break (Full Week)
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9
Tuition Subtotal
Student 1 + Student 2 (sibling discount) + Student 3 (sibling discount)
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10
Final Tuition Calculation
Tuition Subtotal + (Tuition Subtotal * 2.9%) + 0.30
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11
Tuition Due
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( X )
School Break Camp Tuition
USD
+ OR enter a custom value
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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