18 Months to 6 YO Form Child's InformationChild's NameDate of BirthDoes your child have any allergies?YesNoIf yes, please list them:School Currently AttendingGrade in Fall 2025Parent / Guardian InformationMother / Guardian Full NamePhone NumberEmail AddressFather / Guardian Full NamePhone NumberEmail AddressEmergency Contact (Other than Parent/Guardian)Full NamePhoneRelationship to ChildSummer Camp Program (Ages 1-6)Per WeekPer Month5/3 days (Week)5 days week ($350 / w)3 days week ($250 / w)Do you want after care? (5dw)4.00 - 5.30 pm | $60 / weekyesnoDo you want after care? (3dw)4.00 - 5.30 pm | $50 / weekyesno5/3 days (Month)5 days week ($1200 / month)3 days week ($850 / month)Do you want after care? (5dw)4.00 - 5.30 pm | $230 / monthyesnoDo you want after care? (3dm)4.00 - 5.30 pm | $210 / monthyesnoTotalSend Message
