Discovery Child Development Center Summer 2023 Registration Form
Summer enrollment forms will be processed as they are received. All students in summer programs must be potty trained and 3 by August 31, 2023. If you would like to with withdraw or make any revisions to your summer enrollment, please submit a change of summer form to the main office.
Parent or Legal Guardian Information
Parent/Legal Guardian
*
Parent Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Daytime Phone Number
*
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
Second Parent or Guardian (Optional)
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Camper's Information
Last Name
*
First Name
*
Gender
Birth Date
*
January
February
March
April
May
June
July
August
September
October
November
December
Month
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Day
2023
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Year
Camp Selection(s)
Camps are for children ages 3-5. When determine age requirements, calculate based on the age of the camper on August 31, 2023. Morning Camps run from 9 am to 12:10 PM. Full Day Camps are from 9 am to 3:00 pm.
Week of June 19-23
Half Day Camp (Ages 3 and 4) - Let's Go to the Beach
Half Day Camp - (Ages 4 and 5) - Dinosaur Stomp
Full Day Camp - (Ages 4 and 5) - Robot Fun
Week of June 26-30
Half Day Camp (Ages 3 and 4) - Chicka Chicka Alphabet Adventures
Half Day Camp - (Ages 4 and 5) - Robot Fun
Full Day Camp - (Ages 4 and 5) - Dinosaur Stomp
Week of July 10-14
Half Day Camp (Ages 3 and 4) - Planting a Rainbow
Half Day Camp - (Ages 4 and 5) - Mad Scientist
Full Day Camp (Ages 4 and 5) - Superheroes and Fairy Tales
Week of July 17-21
Half Day Camp (Ages 3 and 4) - Water and Bubbles
Half Day Camp (Ages 4 and 5) - Superheroes and Fairy Tales
Full Day Camp -(Ages 4 and 5) - Mad Scientist
Week of July 24-28
Half Day Camp - (Ages 3 and 4) Construction Week
Half Day Camp - (Ages 4 and 5) - Human Body
Full Day Camp - (Ages 4 and 5)- Exploring Pond Life
Week of July 31- August 4
Half Day Camp (Ages 3 and 4) - Buzz Buzz Insect Week
Half Day Camp - (Ages 4 and 5) - Exploring Pond Life
Full Day Camp - (Ages 4 and 5) - Human Body
Week of August 7-11
Things that Go (Ages 3-4) Half Day Camp (Ages 3 and 4)
Half Day Camp - (Ages 4 and 5) - Art Week
Full Day Camp - (Ages 4 and 5) - Art Wee
Would you like to register an additional child?
*
Yes
No
Camper's Information - Sibling
Sibling Last Name
*
Sibling First Name
*
Sibling Gender
Sibling Birth Date
*
January
February
March
April
May
June
July
August
September
October
November
December
Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Sibling Camp Selection(s)
When determine age requirements, calculate based on the age of the camper on August 31, 2023.
Week of June 19-23
Half Day Camp (Ages 3 and 4) - Let's Go to the Beach
Half Day Camp - (Ages 4 and 5) - Dinosaur Stomp
Full Day Camp - (Ages 4 and 5) - Robot Fun
Week of June 26-30
Half Day Camp (Ages 3 and 4) - Chicka Chicka Alphabet Adventures
Half Day Camp - (Ages 4 and 5) - Robot Fun
Full Day Camp - (Ages 4 and 5) - Dinosaur Stomp
Week of July 10-14
Half Day Camp (Ages 3 and 4) - Planting a Rainbow
Half Day Camp - (Ages 4 and 5) - Mad Scientist
Full Day Camp (Ages 4 and 5) - Superheroes and Fairy Tales
Week of July 17-21
Half Day Camp (Ages 3 and 4) - Water and Bubbles
Half Day Camp (Ages 4 and 5) - Superheroes and Fairy Tales
Full Day Camp -(Ages 4 and 5) - Mad Scientist
Week of July 24-28
Half Day Camp - (Ages 3 and 4) Construction Week
Half Day Camp - (Ages 4 and 5) - Human Body
Full Day Camp - (Ages 4 and 5)- Exploring Pond Life
Week of July 31- August 4
Half Day Camp (Ages 3 and 4) - Buzz Buzz Insect Week
Half Day Camp - (Ages 4 and 5) - Exploring Pond Life
Full Day Camp - (Ages 4 and 5) - Human Body
Week of August 7-11
Things that Go (Ages 3-4) Half Day Camp (Ages 3 and 4)
Half Day Camp - (Ages 4 and 5) - Art Week
Full Day Camp - (Ages 4 and 5) - Art Wee
Emergency Contact Info
Emergency Contact Name(if parent or guardian is not avaliable)
*
Emergency Number
*
-
Area Code
Phone Number
Emergency Number #2
*
-
Area Code
Phone Number
Pick Up Authorization
Please list anyone you would like to authorize to pick your child up (in addition to parents/guardians listed above)
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Is there any special information we should know about your child
List any medications to be taken at camp.
List any allergies (ex: bees, peanuts, dairy) or dietary restrictions we should be aware of.
Bilingual
Yes
No
Languages spoken at home
Camper Photo Release
I agree that photos of my child can be taken on used on for camp social media purposes
Yes
No
Playground: Parent gives permission for student to use all the playground equipment and to participate in all activities provided by the school.
*
Initial
Consent for Emergency Treatment
Parent hereby gives permission that Student may be given emergency medical treatment by a qualified staff member at School. Parent also hereby gives permission for Student to be transported by emergency vehicle to the nearest hospital for medical treatment. In the event that Parent cannot be reached or located, Parent further consents to medical, surgical, and hospital care treatment and procedure to be performed by a licensed doctor or hospital when deemed immediately necessary or advisable by the doctor to safeguard Student’s health. Parent further consents to ANY medical care to be performed ON the premises of School and also authorizes ANY necessary emergency medical care to be performed by a licensed medical practitioner. If Student does become ill during school time, School will immediately call the Parent.
Name of Doctor
First Name
Last Name
Name of Medical Practice
Doctor's Phone Number
-
Area Code
Phone Number
Camp Terms
Please initial each item below to agree to our camp policies.
Refunds: Withdrawals for any reason more than 14 days before the start of camp, parents will receive a refund minus $25 per week, per child.
Initial
There are no refunds within 14 days of the start of camp for any reason.
Initial
Missed classes will not be credited or carried over to the next session.
Initial
In the unlikely event that a camp is cancelled, parents will receive notice within five days of the start date. All fees paid will be refunded in full.
Initial
Camp Payment
Check your total camp selections below. Half day camps are $175 for the first week and $165 for each additional week. Full Day camps are $260 for the first week and $245 for each additional week.
*
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next
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Full Day Camps - Check if Registering for Full Day and Choose Quantity Below
$
Free
Please choice the number of full day camps you have signed up for. If you have registered siblings, please add the registrations together (Ex A parent registering for 1 week with 2 children should participating should choose 2, and 2 weeks with two children should choose 4)
Quantity
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Item subtotal:
$
0.00
Number of Half Day Camps Selected
$
Free
Please choice the number of half day camps you have signed up for. If you have registered siblings, please add the registrations together (Ex A parent registering for 1 week with 2 children should participating should choose 2, and 2 weeks with two children should choose 4)
Quantity
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Item subtotal:
$
0.00
Enter coupon
Apply
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: