After School Program Enrollment Form

Herb Knight Summer Recreation Enrollment Form

Summer 2023
We are so excited to be able to offer Summer Rec. again this year! This is going to be an EPIC summer!

Here is our schedule for this summer:

Week One: June 5th-9th

Week Two: June 12th-16th

Week Three: June 19th-23rd

Week Four: June 26th-30th

Week Five: July 5th-7th (3rd & 4th off for Holiday)

Week Six: July 10th-12th

BREAK: JULY 13TH-19TH

Week Seven: July 20th-21st

Week Eight: July 24th-28th

Week Nine: July 31st-Aug 1st

Week Ten: Aug 7th-9th

EPIC SUMMER BASH: Aug 9th!

Hours: 8am-5:15pm

*Breakfast and Lunch provided*

5-day price: $615

3-day price: $500

*Sibling discount offered

*Limited Scholorships available. Email Myra for the application: myra@herbknightcc.org

FULL PAYMENT MUST BE MADE BY JUNE 30TH. If the full payment is not met by this deadline your student(s) will be dropped from the program. If you remove your student after week 3 of the program, you will still be required to fulfill the entirety of your amount due.

Our staff works hard to make summer's fun for your student(s), fulfilling your payments ensures that we honor our staff for their time and hard work, and also ensures that we can provide your student(s) with the best summer possible!

Thank you,

HKCC Team

Please complete and submit one form per student being enrolled in the Summer Rec. Program.
Parent's Name

First NameLast Name
Parent's Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Email
Student's Name

First NameLast Name
Grade in fall (2023-2024)
Please check the enrollment option desired for your child:
Indicate the day(s) that you anticipate utilizing the Summer Rec. Program:
Please note any known allergies:
Please note any known behavioral issues with your student:
Please specify each person, including the name of parents, who has permission to pick up your child from the Summer Rec Program.
Authorized Person 1:

First NameLast Name
Phone Number 1:

Area CodePhone Number
Authorized Person 2:

First NameLast Name
Phone Number 2:

Area CodePhone Number
Authorized Person 3:

First NameLast Name
Phone Number 3:

Area CodePhone Number
Authorized Person 4:

First NameLast Name
Phone Number 4:

Area CodePhone Number
Statement of Fees

*Limited Scholorships available. Email Myra for the application: myra@herbknightcc.org; FULL PAYMENT MUST BE MADE BY JUNE 30TH. If the full payment is not met by this deadline your student(s) will be dropped from the program.
I agree to the payment deadline of June 30th:
Will you be paying in full or need a payment plan?
Program Rules/Expectations
-We expect students to listen to our staff and be respectful to everyone (including other students!)

-We expect students to play fair with others and keep their hands to themselves.

-We operate by a 3 point system; Once your student has hit their 3rd point, they will be suspended from the program.

-We also ask that if there is an issue occuring at Rec. with your student, that you contact our staff and let us know so we can address it. Your student(s) saftey is our biggest priority, please encourage your student to talk with us about things going on!

-BULLYING IS NOT TOLERATED.
"School bullying, like bullying outside the school context, refers to one or more perpetrators who have greater physical strength or more social power than their victim and who repeatedly act aggressively toward their victim. Bullying can be verbal or physical".

-Cell phones and Tablets are not allowed to be out and in use; Cell phones can have exceptions if students ask to call/contact parents.

-HKCC is not responsible for missing/stolen items.

-Pick up is at 5:15pm; if you need a few extra minutes please let a member of our staff know.

It is our goal to make this a fun environment where kids feel comfortable to come and socialize with friends! Communication with you parents helps us with this tremenduously!
SOCIAL MEDIA: I agree to let pictures/videos of my student be posted to HKCC's social media
Signature
Once your submission is recieved, you will be contacted by a member of our staff via HoneyBook. Please keep a lookout in your email! Thank you!
Should be Empty:

Herb Knight Summer Recreation Enrollment Form

Statement of Fees

Program Rules/Expectations