Summer Camp Registration Form

LMS 2025 Summer Camp Registration
Registration Date*

MonthDayYear
Date
CHILD INFORMATION:
Child's English Name*

First NameLast Name
Child's Chinese Name

First NameLast Name
Child's Chinese Name
Birth Date*

MonthDayYear
Date
Gender*

MaleFemale
Child's Age*
Grade Entering*
ex: 4th grade, please type 4
Chinese Learning*

Traditional ChineseSimplified ChineseCSL (Chinese as Second Language)Never learn Chinese
PARENT/GUARDIAN INFORMATION:

** Must enter one parent's/Guardian's information
Father's Name

First NameLast Name
Father's Mobile Number
Please enter a valid phone number.
Father's Email
example@example.com
Mother's Name

First NameLast Name
Mother's Mobile Number
Please enter a valid phone number.
Mother's Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MEDICAL INFORMATION:
Physician's Name

First NameLast Name
Physician's Name*
First and Last Name
Phone Number*
Any allergies or health condition concerns (Please specify)*
Camp Session Tuition and Fees:
$380 per all-day session if registering for only one session

$350 per all-day session if registering for 4 or more sessions

$230 per Monday-Friday AM session (9:00 AM-12:30 PM) if registering for only one session

$220 per Monday-Friday AM session (9:00 AM-12:30 PM) if registering for 4 or more sessions

$250 per Monday-Friday PM session (1:00 PM-5:00 PM) if registering for only one session

$240 per Monday-Friday PM session (1:00 PM-5:00 PM) if registering for 4 or more sessions

$130 per day, Monday-Friday, all day drop-in

$20 per hour, Monday-Friday, hourly drop-in

Early Registration Promotion: $10 off per session if you register by April 15, 2025 (Valid only for the sessions you register for, a five-day, all-day session)

＊Daily session time: Monday through Friday - 9:00 AM ~ 5:00 PM

＊AM session: Pick-up by 12:30 PM; extra charge for late pick-up

＊PM session: Drop-off about 1:00 PM; extra charge for early drop-off

＊Tuition is due upon registration

＊No refund or make-ups will be given for any absences

＊10% sibling discount (Valid only for a five-day, all-day session): Please contact LMS for more information.
Camp & Session Selection:

* Please check the sessions for which you would like to register
1st: 6/9 – 6/13 Classic Chinese Toys

All DayAM OnlyPM Only
2nd: 6/16 – 6/20 Exploring the Fantasy Story

All DayAM OnlyPM Only
3rd: 6/23 – 6/27 Boardgame Adventures

All DayAM OnlyPM Only
6th: 7/14 – 7/18 Fun Science

All DayAM OnlyPM Only
7th: 7/21 – 7/25 Stop Motion Animation Fun

All DayAM OnlyPM Only
8th: 7/28 – 8/1 DIY Decorative Art

All DayAM OnlyPM Only
9th: 8/4 – 8/8 Coding 101

All DayAM OnlyPM Only
10th: 8/12 – 8/15 No summer camp, afternoon activities only

Afternoon (2:30 PM - 6:00 PM) Only
Summer Camp Tuition Fee*
prevnext( X )
All-Day (9:00AM-5:00PM) Session$380 per all-day session if registering for only one session
$380.00 Quantity



4 or more All-Day (9:00AM-5:00PM) Sessions$350 per all-day session if registering for 4 or more sessions
$350.00 Quantity



AM (9:00AM-12:30PM) Only Session$230 per Monday through Friday AM session if registering for only one session
$230.00 Quantity



4 or more AM (9:00AM-12:30PM) Only Sessions$220 per Monday through Friday AM session if registering for 4 or more sessions
$220.00 Quantity



PM (1:00-5:00 PM) Only Session$250 per Monday through Friday PM session if registering for only one session
$250.00 Quantity



4 or more PM (1:00-5:00 PM) Only Sessions$240 per Monday through Friday PM session if registering for 4 or more sessions
$240.00 Quantity



Session 10: August 12 ~ August 15$45 per day from 2:30PM through 6:00PM, no summer camp, afternoon activities only
$45.00 Quantity



Total

$0.00
Dear Parents,

Thank you for registering your child(ren) for our Summer Camp! Please use

the Zelle payment method to pay your child(ren)ʼs Summer Camp tuition:

Zelle Payment account – lmscampus@gmail.com for sending money.

If you have any questions, please donʼt hesitate to contact us.

Monday through Friday 3:00 PM-6:00 PM

Office: (408) 725-2568 (text message available)

Email: lmscampus@gmail.com

Sincerely,

The LMS Team
I HAVE READ THE ABOVE CAREFULLY AND HAVE FULLY UNDERSTOOD THE CONTENT AND CONSEQUENCES OF THESE AGREEMENTS BEFORE SIGNING.
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LMS 2025 Summer Camp Registration

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION:

MEDICAL INFORMATION:

Camp Session Tuition and Fees:

Camp & Session Selection: