Select your Camp(s)
*
Spring Break Camp
Would you like to enroll your child for the 11/23 & 11/24 for $55 per day? *Camp for those two days will be confimed once we have a minimum of 5 enrollments
*
Yes
No
Registering For:
*
Please Select
Full Week Camp
Per Day Option - $50 / day
Select your day(s)
*
Monday
Tuesday
Wednesday
Thursday
Friday
Student Name
*
First Name
Last Name
Student's Date of Birth
*
-
Month
-
Day
Year
Date of Birth
Grade
*
Please Select
K
1
2
3
4
5
6
School
*
School District
*
Allergies
*
To make it easier for us to understand and accommodate your child(ren)'s needs, please add any additional Educational Information about your child below (i.e. ADHD, Dyslexia, etc.) We would like to ensure the safety and value of your child(ren)'s enjoyment at our Camps as much as possible. (Note: You may put "N/A", if applicable)
*
2 - Student Name
*
First Name
Last Name
2 - Grade
*
Please Select
K
1
2
3
4
5
6
2 - School
*
2 - School District
*
Mother Name
*
First Name
Last Name
Mother Email
*
example@example.com
Mother Phone Number
*
Please enter a valid phone number.
Father Name
*
First Name
Last Name
Father Email
*
example@example.com
Father Phone Number
*
Please enter a valid phone number.
Authorized Pickup
*
Mother (as mentioned above)
Father (as mentioned above)
Other
Relation to the child
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Mandatory Pickup/ Drop-Off Policies and Procedures
*
PAYMENT
Select your Camp and Early/ Aftercare option:
*
prev
next
( X )
Week 1: April 1 - April 5
9 AM - 3 PM
$
199.00
Week 2: April 8 - April 12 (Closed on April 9 & 10)
9 AM - 3 PM
$
149.00
Early Care 7 AM- 9 AM
Per week
$
30.00
Aftercare Care 3 PM- 6 PM
Per week
$
30.00
Per Day Option 9 AM - 3 PM
$
50.00
Number of Days
1
2
3
4
5
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Enrollment Agreement
Please Read carefully & SIgn
*
By signing below, i agree to the above enrollment agreement.
*
Date of Consent
*
-
Month
-
Day
Year
Date
How did you hear about us
*
Please Select
Facebook
Email
Whatsapp
Friend
Representative called
Attended an event at GEM
Submit
Should be Empty: