School-Age Summer Enrichment 2024 Registration Form

School-Age Summer Enrichment @ Early Achievers Kindergarten - Summer of Grade 2

35 Hebron Way, St. John's, (709) 579-7323 info@earlyachievers.com
Payment for Summer Enrichment is due in FULL at time of registration. Please ensure the weeks you register for are correct before finalizing your registration, as we do not offer refunds. *Please see cancellation policy below.
Payments can be made via EMT to info@earlyachievers.com, by calling the office at (709) 579-7323 to provide a credit card number, or paying in person at the office. * All credit card transactions are subject to an additional 2.25% user fee.
Child's Name:*

First NameLast Name
Child's Birthday*

MonthDayYear
Date
Grade completed June 2024: *
MCP or alternate Health Care number:
Parent/Caregiver Name (1)*

First NameLast Name
Parent/caregiver Primary Email:*
example@example.com
Phone Number*
Please enter a valid phone number.
Parent/Caregiver Name (2)

First NameLast Name
Parent/caregiver Primary Email:
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact: (Please list a contact other than Parents/Guardians)*

First and Last NamePhone Number
Current marital status of parents:

MarriedSeparatedOther
Do both parents have permission to leave our school with the child?*

YesNo
Please choose your week(s) below: (*4 day week/Week 8 early dismissal on Friday.)

Week 1: June 24 - 28 M-F $260.00 (Enchanted Garden)*Week 2: July 1 - 5 M-F $208.00 (Adventure Land)Week 3: July 8 - 12 M-F $260.00 (Magical Mixtures and Potions)Week 4: July 15 - 19 M-F $260.00 (Cosmic Kids)Week 5: July 22 - 26 M-F $260.00 (Somewhere Over the Rainbow)Week 6: July 29 - Aug. 2 M-F $260.00 (Imaginarium/Inventors Workshop)*Week 7: Aug. 5 - 9 M-F $208.00 (Mission Impossible)*Week 8: Aug. 12 - 16 M-F $234.00 (Water, Water Everywhere)
Does your child have any food allergies?*

YesNo
If yes, please list allergies below:
If your child has allergies, do they require an Epi-Pen? If yes, you will be required to complete and sign an additional Anaphylaxis form.*

YesNo
Is there anything else we should know about your child, to help them adapt and settle into our summer enrichment camp? Does your child have any illnesses, conditions, or special needs that we should be aware of, e.g., asthma, diabetes?*
To provide your child with the best possible experience, it is necessary for us to be aware if your child has been/will be referred to a specialist for speech language, behavioral, social/emotional, or other concerns.*
PHOTO CONSENT: I acknowledge and agree that the staff of Early Achievers may photograph my child. Such photos may be used for promotional materials, social media posts, website ads, etc. Full names will not be used in such publications.*

YesNoOnly for my personal use
In case of emergency, parents/caregivers will be immediately notified. If required, I give permission for treatment by a qualified doctor or any person qualified to give emergency treatment, I release Early Achievers from any liability for injury that may arise or be occasioned thereof. I hereby grant permission for the staff to take whatever steps may be necessary to obtain emergency care, including the use of an ambulance.*

I acknowledge
CANCELLATION POLICY: We understand that children get sick and other interruptions can occur that may interfere in your child’s attendance at Summer Camp on any given day. Although we do not offer refunds, we will try our best to credit this time into another suitable week during Summer Camp 2024, if space is available and a 24-hour advance notice by email is received.*

I acknowledge
Should be Empty:

School-Age Summer Enrichment @ Early Achievers Kindergarten - Summer of Grade 2