2025 Summer Camp Registration Form

Registration: Summer Camp 2025

Please fill out the information below, then select your program and payment option to hold your child's space.
Child's Name*

First NameLast Name
Birth Date*

YearMonthDay
Age*
MaleFemaleNonbinary
Child's school Name *
Which grade level will your child be starting in Fall 2024?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Contact Information
Primary Parent/Guardian*

First NameLast Name
Relationship to Child*
Primary Parent/Guardian Cell Number*
Format: (000) 000-0000.
Primary Parent/Guardian Email*
Does your child have any allergies or health concerns? If yes, please provide details below. If none, write 'None'.*
We are already part of one or more Little Scholar programs!Personal referral (word of mouth)Outdoor signageYelpNextdoorGoogle or other web searchWebsiteOther
Program Options

If you would like to take advantage of our monthly discount, please be sure to purchase the appropriate MONTHLY pass-- all options can be mixed and matched within that pass, and we will be in touch to schedule them with you. Please note: Submitting this form with appropriate registration fees or purchases will reserve your child's space in the program. We will contact you to finalize the registration process, which includes emergency contact information, personal health history, and more.

Summer Camps*

Weekly Enrollment Options

June 2-6

$325.00 Select part time or full timeSelect Camp

June 9-13

$325.00 Select part time or full timeSelect CampAdd -on Swimming ($)

June 16-20

$325.00 Select part time or full timeSelect Camp

June 23-27

$325.00 Select part time or full timeSelect Camp

June30 - July4

$260.00 Select part time or full timeSelect Camp

July 7-11

$325.00 Select part time or full timeSelect CampAdd -on Swimming ($)

July 14-18

$325.00 Select part time or full timeSelect Camp

July 21-25

$325.00 Select part time or full timeSelect Camp

July 28-Aug 1

$325.00 Select part time or full timeSelect CampAdd -on Swimming ($)

Aug 4-Aug 8

$325.00 Select part time or full timeSelect Camp

Lunch Add-On

Lunch and two snacks are provided daily. Please select the number of days your child will need lunch provided..

$10.00 DAY(S)
Item subtotal:$0.00

Before Hour Care

Please select the number of days you will need Before Hour Care.

$25.00 No of Day(s) Care is required
Item subtotal:$0.00

After Hour Care

Please select the number of days you will need After Hour Care.

$25.00 No of Days Care is required
Item subtotal:$0.00

Monthly Enrollment Options

Monthly Enrollment: June

Select from the options below to register monthly and save on tuition. Please note that if you need any specific customization for your family's schedule, any changes can be made after registration.

$1,100.00 Select part time or full time

Monthly Enrollment: July

Select from the options below to register monthly and save on tuition. Please note that if you need any specific customization for your family's schedule, any changes can be made after registration.

$1,100.00 Select part time or full time

Before Hour Care

Please select the number of days you will need Before Hour Care.

$25.00 No of Day(s) Care is required
Item subtotal:$0.00

After Hour Care

Please select the number of days you will need After Hour Care.

$25.00 No of Days Care is required
Item subtotal:$0.00

Daily Pass Options

FULL-TIME DAILY PASS-(8:30am -5:30pm)

$95.00 DAY(S)
Item subtotal:$0.00

PART-TIME DAILY PASS-(8:30am -3:00pm)

$85.00 DAY(S)
Item subtotal:$0.00

Enter coupon

Total

$0.00

Credit Card

If you purchased any add-ons, please list the specific days your child will need Before or After Care and lunch. This information will help us with planning and reservations. If there is nothing to add, please write 'None'.*
If you purchased a Flex Pass, please indicate which days you would like to reserve by using the space below If None, please write 'None'.
Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Little Scholar Programs during the selected camp. In exchange for the acceptance of said child’s candidacy by Little Scholar Programs, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Little Scholar Programs and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Little Scholar Programs including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
Should be Empty:

Registration: Summer Camp 2025

Parent/Guardian Contact Information

Program Options

Credit Card