SGBA SUMMER 2026

Summer Grove Baptist Academy

Summer Program
Date Registered*

MonthDayYear
Date
SGBA Summer Program
Open to Current SGBA Families
6 weeks
4 days/week
Monday - Thursday from 9:00 - 2:00

Weeks of: June 8, June 15, June 22, June 29, July 20, July 27

Registration Fee: $35
Cost: $115 per week

Sessions and Fees are NON-REFUNDABLE
WEEKS:

June 8June 15June 22June 29July 20July 27
Number of Weeks:
1. Name of Child *
1. Date of Birth*
1. Age*
1. Grade (completed)*
2. Grade (completed)
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 #
Best person for daily contact:*
Would you like more information about SG Baptist Church?*

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 #
Other individuals who have permission to pick up your child.

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 allergies and symptoms below.
Is there any additional information we should know about your child(ren)?
Parent Signature*
Should be Empty: