RHM Summer Camp Registration Form

(Current RHM families, please use the Summer form in Transparent Classroom. Thank you.)

Eligibility:

Open to students entering 1st through 6th grade

Program Format:

Week-long summer day camps
Themes change weekly
Attend full summer or select weeks (payment required at form submission)
After-care available (see extended day rates)
Camp Dates: June 8 – August 7, 2026 (Mon-Fri)
Camp hours: 9:00 AM – 3:00 PM ($13/hr charge for late pick up, due at next day drop-off.)
Extended day hours: 7:30 AM – 6:00 PM
No after-hours pickup permitted
Space is limited.
Registration fee: $50
Immunization or exemption record must be on file while in program.

Please contact us with any questions you may have.

Camper's Name*

First NameLast Name

Birth Date*

MonthDayYear

Grade 2026-2027 School Year*

Current School*

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Parent *

First NameLast Name

Cell Number*

Format: (000) 000-0000.

E-mail*

example@example.com

Parent

First NameLast Name

Cell Number

Format: (000) 000-0000.

E-mail

example@example.com

Emergency Information

Please provide the full names, relationship to your child, and phone numbers of two adults authorized to pick up your child from camp if we are unable to reach you in the event of an emergency, accident, or illness.

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Format: (000) 000-0000.

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Format: (000) 000-0000.

Does your student currently take any medications? If yes, please specify.

Is the student prescribed an inhaler? If yes, please explain any instructions.

Does your student have any allergies, chronic illness, or medical conditions we should be aware of, or that may result in an emergency? If yes, please describe, including recommended treatment/procedure.

Does your student have seizures? If yes, please tell us the recommended course of action.

Authorization for Medication

No medication, drugs, or vitamins will be administered to any child except with written permission of the parent or guardian.

In the event of a minor accident, I give my consent for ROSE HILL MONTESSORI SCHOOL personnel to administer first aid. The administration of First Aid may include the use of some over the counter drugs, such as Hydrogen Peroxide, Neosporin or an anti-bacterial ointment, petroleum jelly, calamine lotion, sunscreen, and Benedryl (for emergencies with insect stings/bites only.)

Medications NOT to be administered:

I understand and accept the AUTHORIZATION for MEDICATION statements above.

Authorization for Medical Emergencies

In the event my child should need medical/emergency treatment, and I cannot be reached, I hereby give consent for medical and/or surgical treatment from a licensed physician and/or hospital. I agree that the expense of such emergency care and related transportation costs will be accepted by me.

My hospital of preference is

My child's health insurance company and policy number

Policy account is under the following person's name

I understand and accept the AUTHORIZATION for MEDICAL EMERGENCIES statements above.

Participation in Group Events and Field Trips

I hereby agree, by signing below, to voluntarily assume all risks associated with my child's participation in these activities and to hold ROSE HILL MONTESSORI SCHOOL, it's agents and employees harmless from any and all accidents or injuries occurring at or during these activities.

I understand and accept the PARTICIPATON in GROUP EVENTS and FIELD TRIPS statement above.

Transportation for Group Events and Field Trips

ROSE HILL MONTESSORI SCHOOL may provide transportation for my child in a private or public vehicle for all sanctioned school activites, including field trips.

I understand and accept the TRANSPORTATION for GROUP EVENTS and FIELD TRIPS statement above.

Parent Handbook (School Policies)

To be most informed, read the PARENT HANDBOOK and follow all policies therein.

I have read and understand the PARENT HANDBOOK above and will follow all policies therein.

Cancellation and Refund Policy

If you cancel 7 business days or more before your camp starts:

Full refund, minus a $50 administration fee.
Refunds may be issued back to your original payment method or by check.

If you cancel less than 7 business days before your camp starts or are a 'no-show':

No refunds will be issued.

If you want to exchange camps:

Exchanges must be requested at least 7 business days before camp begins.

I understand the CANCELLATION and REFUND POLICY above.

I attest that all statements on this form are accurrate to the best of my knowledge.*

Choose Day Camps*

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Additional information I'd like Rose Hill Montessori to know:

Registration

(Current RHM families, please use the Summer form in Transparent Classroom. Thank you.)

Camper Information