Montessori Academy Summer Camp 2016

IMPORTANT INFORMATION

Full Day Camp: 9 am to 3 pm: $250 Per week or $2,000 for nine weeks
Half Day Morning Camp: 9 am to 12 pm: $190 Per Week
Before Camp Care: 7 am to 9 am: $30 Per Week
After Camp Care: 3 pm to 5:45 pm $50 Per Week

If your child will arrive before or be picked up after their selected program time, you must also register for before or after care.  Early drop offs (Before 8:50am) or late pick ups (After 3:05pm) will be billed for these programs.  

Each weekly session is five full or half days.  No partial weeks are available.  
Pickup during Before and After Care is flexible during designated hours.  Students may arrive or leave at any time during those programs.

Students are Required to Bring:
Filled Reusable Water Bottle Labeled with Name (No Disposable Water Bottles)
Healthy Lunch* in a reusable, insulated container w/freezer pack.  
Breakfast* if arriving before 8:00AM, Afternoon snack* if staying after 4:00PM.
*We are a completely NUT FREE Campus. Never send nuts or nut products of any kind.

Students are Required / Encouraged to Wear:
Sun Protective Gear: Hats, Protective Clothing
Arrive Wearing Sunscreen and Insect Repellent*
*Camp staff is not able to apply sunscreen or insect repellent.  
Sturdy summer shoes or sandals for playing outside.  Flip Flops are unsafe.

Please fill out the enrollment form below for each new elementary student (Age 6-12, Entering First Grade- Entering Seventh Grade). 

Student Information
Student Birth Date *
Student Birth Date
Birth Date
Student's Age at time of Enrollment
Student Home Address *
Student Home Address
Parent / Guardian Information
Name of Enrolling Parent / Guardian *
Name of Enrolling Parent / Guardian
Parent / Guardian Contact Phone
Parent / Guardian Contact Phone
First Name Last Name, Street Address, City
Pediatrician Phone Number
Pediatrician Phone Number
Emergency Contact Information
First Name Last Name, Street Address, City
Emergency Contact #1 Phone Number *
Emergency Contact #1 Phone Number
First Name Last Name, Street Address, City
Emergency Contact #2 Phone Number *
Emergency Contact #2 Phone Number
Persons Authorized to Pick Up Your Student
Name and Relationship to Child
Primary Pickup Person Phone Number *
Primary Pickup Person Phone Number
Name and Relationship to Child
Other Pickup Person #1 Phone Number *
Other Pickup Person #1 Phone Number
Other Pickup Person #2 Phone Number
Other Pickup Person #2 Phone Number
Summer Camp Program Informaiton
Program Selection by the Week *
Camps are for five full days OR five half days. Select by checking the boxes next to either half day or full day camp, also check the boxes for any before or after care options required.
Getting to Know Our New Student
Please list and explain any important medical conditions, history or other concerns that Montessori Academy needs to know to educate your child.
Please list any known allergies your child may have.
Allergy Protocol *
Acknowledgements
Camp Tuition *
Cancellation Policy *
Medical Refunds *
Enrollment Fee *
Electronic Signature *
Electronic Signature
I am submitting my full name below as an electronic signature stating that the information I have provided is true and accurate.