2019 Summer Camp Registration

Join us for 4 or 8 fun-filled days that include art, games, stories, music, and many other activities.

Cost:

Extra Early Bird Rate through April 1 - $220 for both weeks (you have to sign up for both weeks to get this rate) OR $115 for a single week

Early Bird Rate through May 1 - $120 per week

Regular Rate starting May 2 - $135 per week

Who: Any child ages 2-6 or any current student of ELNS

Where: Epiphany Lutheran Nursery School, 1400 Horsepen Rd., Richmond VA

Time: 9:00 am - 12:00 p.m. (dropoff beginning at 8:45am)

When: Week 1: May 30-June 2; Week 2: June 5-8

Themes: Week 1: Artistic Adventures Week 2: Amazing Animals

Class sizes are limited and spots will be filled on a first-come, first-served basis. Camp tuition is non-refundable if you should cancel at any point.

Please fill out this registration form and click the submit button at the bottom. You will be asked to visit our online payment site to submit payment (we use Cheddar Up) or you can bring in a check or mail in payment to the school. Your registration will not be complete until you have submitted payment.

How many children will be attending camp?*

Child #1*

First NameLast Name

Child #1 Birthdate*

MonthDayYear

Child #1 Gender*

Child #2

First NameLast Name

Child #2 Birthdate

MonthDayYear

Child #2 Gender

Child #3

First NameLast Name

Child #3 Birthdate

MonthDayYear

Child #3 Gender

Please select which week(s) of camp you would like your child(ren) to attend.*

May 30 - June 2June 5-8

Home Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Home Phone

Area CodePhone Number

Family E-Mail*

Confirmation EmailAll camp information will be sent via email.

Mother's or Guardian's Name*

First NameLast Name

Cell Phone*

Area CodePhone Number

Father's or 2nd Guardian's Name*

First NameLast Name

Cell Phone*

Area CodePhone Number

Please tell us about any special concerns for your child that you feel the staff should know. (ex: allergies, medical concerns, separation anxiety, etc.)*

Please list anyone, other than the parents/guardians listed above that is authorized to pick up your child(ren)during summer camp. Please include their phone numbers.*

Is your child currently enrolled in a preschool?*

Which preschool?

Please list your child's physician.*

Physician's Phone Number*

Area CodePhone Number

By clicking on the submit button below:

You agree that if notified by Epiphany Lutheran Nursery School that your child has become ill, you will pick the child up as soon as possible.

You authorize Epiphany Lutheran Nursery School to obtain immediate medical care if any emergency occurs when you cannot be located immediately.

You give permission for your child's picture or video to be taken during summer camp and used for scrapbooks, bulletin boards, training, preschool programs, and marketing. You understand they will not be used for any other purpose and names will never be included with the photos to protect confidentiality.

ELNS 2023 Summer Camp Registration