LEAPSTART SUMMER CAMPS Enrollment form

2026 LEAPSTART SUMMER CAMPS ENROLLMENT FORM

ACTIVE DISCOUNTS!

Sibling Discount of $20 per camp for each child!

&

Refer New Customers and you both get $20 Off per camp

*Weekly Lunch - Cuisine includes Italian, American, Indian and Chinese.

Student Information

Existing AFTER SCHOOL Student at Leapstart?

Registering siblings?

Sibling discount is available for parents registering multiple children

Sibling Names

Enter sibling names separated by comma

First Name

Last Name

DOB

Date

Gender

School Name

Grade

Home Street Address

City

Zip Code

State

Referred By

If you are referred by an existing customer of Leapstart, pl. mention their name here.

Any Allergies or other medical conditions that our staff needs to be aware of?

Parent Information

Mother"s Name

Mother's E-mail

Mother's Phone

Mother's Employer

Father"s Name

Father's E-mail

Father's Phone

Father's Employer

Emergency Contact & phone

Location Information

Bubb: 10650 Bubb Rd Cupertino, CA, 95014

De Anza: 10594 S De Anza Rd Cupertino, CA, 95014

Camps Information

June 15th - June 19th

June 22nd - June 26th

June 29th - July 2nd (4 Day Camp)

July 6th - July 10th

July 13th - July 17th

July 20th - July 24th

July 27th - July 31st

Aug 3rd - Aug 7th

Aug 4th - Aug 8th

Payment Information

Referred By

Final $

Transaction Date

Date

EB Discount 1

EB Discount 2

EB Discount 3

EB Discount 4

EB Discount 5

EB Discount 6

EB Discount 7

EB Discount 8

EB Discount 9

EC Discount 1

EC Discount 2

EC Discount 3

EC Discount 4

EC Discount 5

EC Discount 6

EC Discount 7

EC Discount 8

EC Discount 9

Early Bird Discount Applied

Total Camp Count

Multiple Camps Discount

Holi Discount

Sibling Discount

$20 Off sibling discount per camp per enrollment

PROMO Discount

Congratulations! You qualify for PROMO discount ON YOUR TOTAL. The discount will be automatically applied to your total.

Congratulations! As one of our Last Minute Families, you qualify for a special DISCOUNT of $20 PER CAMP.

The discount will be automatically applied to your total.

Congratulations! You qualify for Sibling discount of $20 OFF each camp. The discount is automatically applied to your total.

Congratulations! You qualify for Early Bird discount. The discount is automatically applied to your total.

Congratulations! You qualify for 2 camps discount of $20 per camp for a total of $40! The discount is automatically applied to your total.

Congratulations! You qualify for 3 camps discount of $30 per camp for a total of $90! The discount is automatically applied to your total.

Congratulations! You qualify for 5 camps BONUS discount of $50! The discount is automatically applied to your total.

Congratulations! You qualify for 7 camps BONUS discount of $140! The discount is automatically applied to your total.

Congratulations! You qualify for 8 camps BONUS discount of $240! The discount is automatically applied to your total.

Congratulations! You qualify for our biggest discount of FREE EXTENDED CARE AND FREE LUNCH! The extended care and lunch need not be added to your order.

Pick an option to apply 5 or more camp discount

Calculated Total

Sum Total of all camps without discount

HAVE A PROMO CODE?

Payment Total

USDLeapstart Summer Camps fee

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Payment Total*

Payment Methods

Payment Total