SGBA SUMMER 2025

Summer Grove Baptist Academy Summer Program
Date Registered*

MonthDayYear
Date
SGBA's Summer Program is for five weeks, three weeks in June and two weeks in July.

Weeks of: June 10, June 17, June 24, July 15, July 22

Tuesday - Friday from 9:00 - 2:00

Ages: 8 wks - 3rd Grade

Registration Fee: $35
Cost: $115 per week

* If registering for all five weekly sessions, you will receive a $50 discount

Sessions and Fees are NON-REFUNDABLE
WEEKS:

June 10June 17June 24July 15July 22
Number of Weeks:
1. Name of Child *
1. Date of Birth*
1. Age*
1. Grade (completed)*
2. Name of Child
2. Date of Birth
2. Age
2. Grade (completed)
3. Name of Child
3. Date of Birth
3. Age
3. Grade (completed)
Best person for daily contact:*
Child's Home Address*
City*
State*
Zip Code*
Mother's Name*
Mother's Cell #:*
Mother's Email:*
Mother's Work #:
Father's Name*
Father's Cell #*
Father's Email*
example@example.com
Father's Work #
Are you a member of SGBC?*

YesNo
Emergency contacts if parents cannot be reached.

Please include relation/nickname if applicable (e.g. Carol Smith (grandma/Grammy)
1. Name*
1. Phone #*
2. Name
2. Phone #
Names of individuals other than parents who have permission to pick up your child(ren).

Please include relation/nickname if applicable (e.g. Jason Smith [Grandpa/Pops]).
1*
Phone Number*
Please enter a valid phone number.
2
Phone Number
Please enter a valid phone number.
3
Phone Number
Please enter a valid phone number.
Do any of your children have allergies?*

YesNo
If YES: please list child's name, allergies, and symptoms below.
Is there any additional information we should know about your child(ren)?
Parent Signature*

Clear
Should be Empty:

Summer Grove Baptist Academy Summer Program