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Registration for Early/After Care

Camper Information
Dates: June 22- July 17, 2026

Monday - Friday

Before care 8:30am - 9am $10 a day/$50 a week

After care 3:30pm - 5pm $15 a day/$75 a week
Number of Children Registering for Early or After Care*
Camper 1
Full Name*
First Name Last Name
Date of Birth*

Month Day Year
Grade*
My child/children will be attending:*

Before CareAfter Care
Attending Before Care:*

DailyWeekly
Attending After Care:*

DailyWeekly
Child 1: My child/children will be attending 8:30am-9am:*

June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17
Child 1: My child/children will be attending 3:30pm-5pm:*

June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17
Child 1: My child/children will be attending 8:30am-9am:*

Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17
Child 1: My child/children will be attending 3:30pm-5pm:*

Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17
Camper 2
Full Name*
First Name Last Name
Date of Birth*

Month Day Year
Grade*
My child/children will be attending:*

Before CareAfter Care
Attending Before Care:*

DailyWeekly
Attending After Care:*

DailyWeekly
Child 2: My child/children will be attending 8:30am-9am:*

June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17
Child 2: My child/children will be attending 3:30pm-5pm:*

June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17
Child 2: My child/children will be attending 8:30am-9am:*

Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17
Child 2: My child/children will be attending 3:30pm-5pm:*

Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17
Camper 3
Full Name*
First Name Last Name
Date of Birth*

Month Day Year
Grade*
My child/children will be attending:*

Before CareAfter Care
Attending Before Care:*

DailyWeekly
Attending After Care:*

DailyWeekly
Child 3: My child/children will be attending 8:30am-9am:*

June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17
Child 3: My child/children will be attending 3:30pm-5pm:*

June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17
Child 3: My child/children will be attending 8:30am-9am:*

Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17
Child 3: My child/children will be attending 3:30pm-5pm:*

Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17
Parent Information
Father's Name*
First Name Last Name
Mobile*

Area Code Phone Number
E-mail*
Mother's Name*
First Name Last Name
Mobile*

Area Code Phone Number
E-mail*
Payment
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%