SATURDAY SUMMER IN-PERSON FOR KIDS AGES 1-11 2023

2023 KIDS IN-PERSON SUMMER WEEKEND ENROLLMENT FORM

Ages 18 months-11. PLEASE SUBMIT FORM WITH PAYMENT IN FULL. One Form per Family 07/08/23-08/05/23 (4-5 WEEKS AVAILABLE)
FAMILY INFORMATION
Family Last Name*
Family E-Mail *
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother’s Name*

First NameLast Name
Cell Number*
House/Phone Number
Work Number
Job Title
Father’s Name*

First NameLast Name
Cell Number*
Please enter a valid phone number.
House/Phone Number
Work Number
Please enter a valid phone number.
Job Title
EMERGENCY INFORMATION
Emergency Contact/Other Than Parent*

First NameLast Name
Emergency Contact Cell Number*
Please enter a valid phone number.
Relationship to Child*
Health Problems/Allergies, or Other Important Information for Child/ren: *
Please list important information we should know about your child. Let the program director know the severity of any allergies.
1st STUDENT INFORMATION
Student Name*

First NameMiddle NameLast Name
Grade on September 2023*
Birth Date*

MonthDayYear
Gender*
CHOOSE ANY 4 or 5 WEEKS*

4 weeks5 weeks
INDICATE DAYS ATTENDING*

07/08/2307/15/2307/22/2307/29/2308/05/23
INDICATE PROGRAM*

Mommy & Me (18 months-2.11 years old) : SATURDAY 9:00-9:45 AMMommy & Me (18 months-2.11 years old): SATURDAY 10:00-10:45 AM3-5 Year Old (Must be 3 by 07/01/23, entering Nursery/Pre-k to Kinder in Sept, 23) : SATURDAY, 9:00 AM-10:30 AM6-8 Year Old(Entering 1st-3rd Grade in Sept,23): SATURDAY, 9:00 AM-10:30 AM9-11 Year Old (Entering 4th-6th Grade in Sept,23): SATURDAY, 9:00 AM-10:30 AM
2nd STUDENT INFORMATION
Student Name

First NameMiddle NameLast Name
Grade on September 2023
Birth Date

MonthDayYear
Gender
CHOOSE ANY 4 or 5 WEEKS

4 weeks5 weeks
INDICATE DAYS ATTENDING

07/08/2307/15/2307/22/2307/29/2308/05/23
INDICATE PROGRAM

Mommy & Me (18 months-2.11 years old) : SATURDAY 9:00-9:45 AMMommy & Me (18 months-2.11 years old): SATURDAY 10:00-10:45 AM3-5 Year Old (Must be 3 by 07/01/23, entering Nursery/Pre-k to Kinder in Sept, 23) : SATURDAY, 9:00 AM-10:30 AM6-8 Year Old(Entering 1st-3rd Grade in Sept,23): SATURDAY, 9:00 AM-10:30 AM9-11 Year Old (Entering 4th-6th Grade in Sept,23): SATURDAY, 9:00 AM-10:30 AM
POLICIES & PROCEDURES
TUITION:

Full tuition is due upon registration.
DISCOUNT

Only one per child & can not be combined with any other offer. SIBLING Discount: 10% off lesser tuition.
NO REDUCTION OR PRO-RATED DISCOUNTS FOR ABSENCES

Tuition is NEVER PRO-RATED or REDUCED for ABSENCES, SICKNESS (INCLUDING COVID,) VACATIONS and program closings due to INCLEMENT WEATHER. FAMILIES HAVE THE OPTION OF ENROLLING FOR OUR 4 or 5 WEEKS.
WITHDRAWAL

I understand that a class space is reserved for each student. A written notice via email MUST BE SUBMITTED by June 1ST, 2023 to receive a full refund . If a student withdraws from the SATURDAY program after June 1st, there will be a charge for classes ATTENDED or UNATTENDED up to 35 days AFTER a withdrawal letter is given to AAS indicating date of notice and the last date my child/ren will attend our program.

****Please note that “35-days” represents 5 weeks tuition**
NO MAKE-UPS CLASSES FOR ABSENCES

No make-up classes are offered for the summer session for missed classes due to absences, vacations, sickness (including Covid related) and program closings due to inclement weather. Classes can not be carried over to the next session.
MEDIA

Pictures and videos of our students are often posted weekly on our Facebook/ Instagram/Twitter accounts, website & newsletters. Please check I agree for YES if you would like your child to be able to participate in pictures and videos. LEAVE blank for NO
Discount Options

One Discount per child. CANNOT COMBINE discounts.
Sibling 10% OFF Discount-CODE: SIBLING23
Payment

Full Payment is required for submission*

Mommy and Me 4 WEEKSPlease enter a short description.

$155.00

Mommy and Me 5 WEEKS

$180.00

1st Child (3-11 Year Old Program) 4 Weeks

$180.00

2nd Child (3-11 Year Old Program) 4 Weeks

$180.00

1st Child (3-11 Year Old Program) 5 Weeks

$220.00

2nd Child (3-11 Year Old Program) 5 Weeks

$220.00

Enter coupon

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Signature for Credit Card Payments

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2023 KIDS IN-PERSON SUMMER WEEKEND ENROLLMENT FORM

FAMILY INFORMATION

EMERGENCY INFORMATION

1st STUDENT INFORMATION

2nd STUDENT INFORMATION

POLICIES & PROCEDURES

Discount Options

Payment

Payment Methods