Summer at MLS Registration Form 2024

Family Information
Parents Marital Status*
Mother
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Father
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Home Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Family
Will you be sending one of your children to My Little School for the first time next year (Fall 2024)?*

YesNo
Child's Name*
Authorized Pickup
In addition to the child's parents, I authorize the following people to pick up my child:*

Payment

MLS Summer Payment

USDRegistration Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Parental Consent
By signing my name in the box below, I agree to pay the full tuition for the period indicated on this enrollment form.
By signing my name in the box below, I agree to pay the full tuition for the period indicated on this enrollment form. The deposit amount of $700 per child is entirely non-refundable and non-transferable.
By signing my name in the box below, I acknowledge that no tuition refunds for early bird registrations will be processed after 03/14/2024. All early bird registrations are deemed final as of 03/15/2024. Additionally, I acknowledge that no tuition refunds for full price tuition will be accommodated after 04/14/2024, and all full price tuition registrations are finalized as of 04/15/2024.
By signing my name in the box below, I agree to the following terms: I hereby permit my child(ren) to participate in all activities at Chabad of Tribeca/My Little School 2024, on-site, off-site and on any trips. I release Chabad of Tribeca/My Little School and all individuals from any liability arising out of any injury to my child(ren). I understand that my child(ren) may be dismissed during a camp day, due to illness, at the discretion of the camp, and I agree to abide by the director’s decision. In the event of a medical or surgical emergency, I grant permission to the physician designated by Chabad of Tribeca/My Little School to hospitalize, secure proper treatment for and order injections, anesthesia or surgery for my child(ren). Furthermore, I understand that payment for medical services is solely the family’s responsibility.
Parent Signature*

Clear
Parent Name*

First NameLast Name
Your Email Address*
This email address will receive a confirmation email upon submission
Should be Empty:

Welcome to Summer at MLS!

Child's Age Group

Select Sessions

My Little Class - Toddlers

My Big Class - Turning Twos/ Ladybugs

Older 2’s Class/ Hummingbirds

Younger 3's Class/ Fireflies & Bluejays

The 3's Class/ Fireflies & Bluejays

Younger 4's Class/ Butterflies

4 and 5's Class/ Owls and Sparrows

Summer at MLS Registration 2024

Child 1

School

Medical Information

Child 2

School

Medical Information

Child 3

School

Medical Information

Family Information

Mother

Father

Home Information

Family

Authorized Pickup

Payment

Parental Consent