2025 Summer Camp Registration

Clover Presbyterian Preschool Summer Camp Registration 2025
- $165 per Week Per Camper
- $25 non refundable deposit per week per child at time of registration
Email for Important Registration Information *
example@example.com

Child Information
Child's First Name*
Child's Last Name*
Birthdate *

MonthDayYear
Date
Age on June 1, 2025*
Camp Weeks (All Camps are Monday - Thursday |8:30am - 12:30pm)
Please select the camp(s) for your child.

Nature Camp June 9-12Frozen Summer June 16-19Under the Sea Camp June 23-9Safari Camp June 30-July 3Princess and Super Hero Camp July 7-10Art and STEM Camp July 14-17Carnival Camp 21-24
My child is a current student or has enrolled for the 2025-2026 School Year at Clover Presbyterian Preschool. The emergency contacts and medical information has not changed.

Yes, my child is enrolled and the information is the same.No, my child is not enrolled and/or their medical information needs to be updated.

What experiences do you expect your child to gain from the Clover Presbyterian Preschool Program?*
Does your child have any fears?*
What do you do at home to comfort your child?*
Do you have any concerns about your child's development?*

Household Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 1*

First NameLast Name
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 1 Phone*
Please enter a valid phone number.
Do you need to add another Parent/Guardian?*

YesNo
Parent/Guardian 2*

First NameLast Name
Parent/Guardian 2 Email*
example@example.com
Parent/Guardian 2 Phone*
Please enter a valid phone number.
Does your child have siblings?*

YesNo
Names and ages of siblings living in the home. *

Authorization for Medical Information
I hereby grant permission for any staff person from Clover Presbyterian Preschool to take whatever steps may be necessary to obtain emergency medical treatment for my child. These steps include, but are not limited to the following:
1. Attempt to contact parent or guardian.
2. Attempt to contact the child's physician.
3. Attempt to contact the parent through any of the emergency contacts listed below.
4. If we cannot contact you, we will call an ambulance and have your child taken to the emergency room.
I agree and understand the above statement.
I understand that I am responsible for any resultant medical treatment expenses.
Emergency Contact 1*

First NameLast Name
Emergency Contact 1 Phone *
Emergency Contact 2*

First NameLast Name
Emergency Contact 2 Phone *
Emergency Contact 3*

First NameLast Name
Emergency Contact 3 Phone *
Is your child covered by personal/family medical insurance?*

YesNo
Insurance Company and Policy Number*

Authorized Pick Up
If my child is to be picked up by anyone other than myself or spouse, I will notify the teacher in writing or in the case of emergency will call the preschool.

I understand that anyone listed below may pick up my child. These individuals must provide a picture ID.
If my child is to be picked up by anyone other than myself or spouse, I will notify the teacher in writing or in the case of emergency will call the preschool.
I understand that anyone listed below may pick up my child. These individuals must provide a picture ID.
Authorized Pick Up 1*

First NameLast Name
Authorized Pick Up 1 Phone *
Authorized Pick Up 2*

First NameLast Name
Authorized Pick Up 2 Phone *

Security Video Release and Acknowledgement

In order to promote the safety of children, staff and visitors, Clover Presbyterian Preschool has video surveillance cameras throughout the facility, excluding restrooms.
I acknowledge and have been notified of the video surveillance cameras

Photo Release

We love to take pictures at Clover Presbyterian Preschool Summer Camp. We use them to create bulletin boards, advertise on Social Media, enhance the CPC website, and to show the kids having fun, playing, and learning. We would like your permission to photograph/videotape your child for use in these projects. Photos will remain the property of CPP unless otherwise noted.
Please check all that apply:*

I give my permission for any photo/video to be taken by preschool staff and included in marketing materials such as website, social media, advertisements, etc. for the discretional use for Clover Presbyterian Preschool.DO NOT USE MY CHILD'S PHOTO

Non Refundable Deposit:

A non refundable deposit of $25 per week, per child is due at time of registration. This deposit goes towards the weekly balance. For example, if you sign up for one week of camp ($165), $25 is due at time of registration (this is non refundable, even if you cancel your week of camp), the remaining balance of $140 is due on or by June 1st, 2025). After June 1st, 2025 the full camp tuition is non refundable unless a doctor's note is provided.
I acknowledge that my child's spot in the 2025 Clover Presbyterian Preschool Summer Camp is not secure until I have paid a non refundable $25 deposit per week, per child.
Weekly Tuition:

Tuition for all June camp weeks is due by June 1st, 2025. Tuition for all July camp weeks is due by July 1st, 2025. If tuition is not received by the first of each month, your child will be removed from the camp roster. After the first of each month, the tuition is non refundable.
I understand camp tuition is due in full on the first of each month and after the first, is not refundable.
Payment Methods

Check and cash are the preferred method of payment for Clover Presbyterian Preschool. Electronic payments with debit or credit cards will be charged a $5 convenience fee to cover the processing fees.
I would like to pay electronically. understand that if I opt to use a debit or credit card, I will be charged a $5 convenience fee for each transaction. By checking this box, I will be on the lookout for an invoice from Procare.I would like to pay with Check or Cash. I will bring a check or cash to Clover Presbyterian Preschool during open hours and drop it in the 'Preschool Information' box to the right of the front door (8am-1pm; Monday- Friday).
Should be Empty:

Child Information

Camp Weeks (All Camps are Monday - Thursday |8:30am - 12:30pm)

Household Information

Child Health Record

Authorization for Medical Information

I hereby grant permission for any staff person from Clover Presbyterian Preschool to take whatever steps may be necessary to obtain emergency medical treatment for my child. These steps include, but are not limited to the following:

Authorized Pick Up

Security Video Release and Acknowledgement

Photo Release

Non Refundable Deposit:

Weekly Tuition:

Payment Methods