Summer 2025 Highcroft Enrichment Program Registration Form

Highcroft Montessori Summer Enrichment Program Rate

Thank you for beginning the registration process for the Highcroft Montessori Enrichment Program for students in grades 1-6. The nonrefundable payment for selected days/weeks is paid in full at the time of registration. Your registration will not be finalized until payment is processed.

Pricing Information:

Weekly Cost (Monday – Friday, 5 days): $325.00
Daily Cost: $65.00
Families have the flexibility to choose their desired days of attendance.

Payment Details:

All payments will be paid in full and made electronically via credit card.

Important Information:

Families are asked to maintain a consistent weekly schedule for the camp weeks they select. For example, you might choose M/W/F for weeks 1, 5, and 7, or M/T/W/Th/F for weeks 1-10.

Scheduling Policy:

If a family cannot attend a registered week, they may request to switch to an alternative week, subject to availability. However, payments are nonrefundable due to staffing and scheduling considerations.

First Name*

Middle Name*

Last Name*

MaleFemale

Address*

City*

State*

Zip*

Birth Date*

MonthDayYear

Grade entering in the fall (school year 2025/2026)*

Parent/Legal Guardian*

Relation*

Email

example@example.com

Work Phone*

Area CodePhone Number

Cell Phone*

Area CodePhone Number

Parent /Legal Guardian 2*

Relation 2*

Email

example@example.com

Work Phone 2*

Area CodePhone Number

Cell Phone 2*

Area CodePhone Number

Home Phone*

Area CodePhone Number

Emergency Contact 1 Name (if parent or guardian is not avaliable)*

Emergency Number*

Area CodePhone Number

Emergency Number #2*

Area CodePhone Number

Emergency Contact 2 Name (if parent or guardian is not avaliable)*

Emergency Number*

Area CodePhone Number

Emergency Number #2*

Area CodePhone Number

Preferred Primary Email for Communication during the Summer *

List any allergies (ex: bees,peanuts, dairy)

Any dietary needs that we should know about?

Any activity the student should be restricted from?

First Aid and Bandages: I give my consent that in the event my camper is slightly injured (cut, scraped, bruised) during regular activity, Hand In Hand is authorized to take one or more of the following actions: wash the cut with warm water and place a bandage on the area (no ointment will be applied). If the child needs another type of First Aid, I authorize the staff to use their First Aid training and discretion in this area. I understand I will be notified in writing when I return that my student sustained a mild injury during the course of the day.

YesNo

Yes, I understand

Liability Release: I give my consent for my student to participate in Hand In Hand’s daily activities approved by the directors, assistants, and other Hand in Hand representatives. I understand that by participating in certain physical activities my child may be exposed to risks. I understand that Hand In Hand does not assume any responsibility in case an accident occurs. I hereby release and indemnify Hand In Hand leadership and Board of Directors from any and all liability claims suffered by my camper while involved in normal, daily activities.

Yes, I understand

YesNo

My electronic signature below acknowledges and gives consent for the above three releases: "First Aid and Bandages Release", "Medical Release", and the "Liability Release". This electronic signature also secures my response to the "Media Release".

Week 1 Value

Week 2 Value

Week 3 Value

Week 4 Value

Week 5 Value

Week 6 Value

Week 7 Value

Week 8 Value

Week 9 Value

Week 10 Value

Week 11 Value

Week 12 Value

Total Payment Due

Camp Registration Total

USDTotal Highcroft Camp Payment

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

Credit CardCheque

Be certain to enter your email address correctly on the registration form to receive confirmation via email with in 2 weeks

By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named camper by authorized personnel. The camp carries secondary insurance. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activites.

Electronic signature, please initials*

Student's Information

Parent or Legal Guardian Information

Emergency Contact Info

Email Confirmation

Health Information

Photo Release

Acknowledgements & Consents

Payment Information