Summer Session Enrollment Form

Emergency Notification Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to Student*
Please list all adults who are allowed to drop off/pick up student.
Valid, current ID will be needed for pick ups.

Does the Student have any food allergies?*

YesNo
If yes, please describe/list foods.
Does the student have any medical conditions/needs?*

YesNo
If yes, please describe.
Will the student require any medication during the day?*

YesNo
If yes, please describe.
There is no licensed nurse on staff - so parents would have to come and administer the medication.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Summer Session '25