Grace Preschool Admissions Form

Grace Preschool Daycamp Admissions Form
There are three different day camps to choose from this summer. Camps are limited to 30 campers and first-come-first-serve. Please check the applicable camp(s) below and make payment here.

Sing Praise and Splash Preschool Daycamp
June 17 and June 19
9:00 am-12:00 pm
Ages 2-6
$80/child

Wonders of Creation Science Preschool Daycamp - FILLED

Reflecting God's Glory in Creating Crafts Preschool Daycamp
July 15 and 17
9:00 am-12:00 pm
Ages 2-6
$80/child
June 17, 19 (9am-12pm); ages 2-6; $80/child
July 15, 17 (9am-12pm); ages 2-6; $80/child
Child's Name*

First NameLast Name
Child's Present Age*
Child's Birth Date*

MonthDayYear
Date
Gender*
Allergies, medical and special needs:
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
Primary Phone*
Work Phone
Cell Phone
Emergency Contact 1 (if parent/guardian cannot be reached)*
Emergency Contact 2 (if parent/guardian cannot be reached)
Approved Pick Up 1*
Approved Pick Up 2
YesNo
YesNo
Authorization for Emergency Medical Care

If I cannot be reached to make arrangements for emergency medical care for my child at the time of an illness or accident I give my permission for the Grace Preschool, LLC Director or Manager to take my child to the following Doctor and/or Hospital:
Emergency Medical Attention (Physician)
Emergency Medical Attention (Hospital)
Should be Empty:

Grace Preschool Daycamp Admissions Form