Children's Registration Form - Summer Celebration (lectureship)

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Summer Celebration (lectureship)

Summer Celebration 2009 Survey

Children's Registration Form

Summer Celebration (lectureship) > Children's Registration Form

2009 Children Program Registration

Please complete this for up to three children registering. The Children's Program is for children ages 0 to 12 (entering sixth grade) Older children should be registered in the Teen Program.
Summer Celebration Adult Contact Last Name
Summer Celebration Adult Contact First Name
Email Address
Street Address
City
State
Zip Code
Cell Phone Number
Alternate Cell Phone Number
Number you can be reached while at Summer Celebration
Where you are staying while at Summer Celebration
The Nursery is for children ages infant to 23 months. It is available from 9:30-Noon and from 2-4:30 p.m.
Preschool Day Care includes ages 2-Kindergarten. Classes will be provided from 9:30 AM -Noon and 2-4:30 PM.
Day Camp is for children entering first grade through age 12. Hours will be 8:30 a.m. until 4:30 p.m. and includes lunch.
CHILD 1 first name
CHILD 1 last name
Enroll CHILD 1 in Nursery (0-23 months)
Preschool (2 yrs -beginning kindergarten)
Day Camp (completed kindergarten-age 12)
CHILD 1 Allergies or other medical conditions that require special attention
CHILD 1 Birthdate (mm/dd/yyyy)
Please check boy
girl
For Day Camp, grade for 2008-2009
Please register CHILD 1 for Two Days
Other
If other, please specify
CHILD 2 first name
CHILD 2 last name
Enroll CHILD 2 in Nursery (0-23 months)
Preschool (2 yrs -beginning kindergarten)
Day Camp (completed kindergarten-age 12)
CHILD 2 Allergies or other medical conditions that require special attention
CHILD 2 Birthdate (mm/dd/yyyy)
Please check boy
girl
For Day Camp, grade for 2008-2009
Please register CHILD 2 for Two Days
Other
If other, please specify
CHILD 3 first name
CHILD 3 last name
Enroll CHILD 3 in Nursery (0-23 months)
Preschool (2 yrs -beginning kindergarten)
Day Camp (completed kindergarten-age 12)
CHILD 3 Allergies or other medical conditions that require special attention
CHILD 3 Birthdate (mm/dd/yyyy)
Please check boy
girl
For Day Camp, grade for 2008-2009
Please register CHILD 3 for Two Days
Other
If other, please specify
Please use another form to enroll additional children.
* Type both words below, separated by a space.
Can't read the words below? Try different words or an audio captcha.

Summer Celebration Adult Contact Last Name
Summer Celebration Adult Contact First Name
Email Address
Street Address
City
State
Zip Code
Cell Phone Number
Alternate Cell Phone Number
Number you can be reached while at Summer Celebration
Where you are staying while at Summer Celebration
The Nursery is for children ages infant to 23 months. It is available from 9:30-Noon and from 2-4:30 p.m.
Preschool Day Care includes ages 2-Kindergarten. Classes will be provided from 9:30 AM -Noon and 2-4:30 PM.
Day Camp is for children entering first grade through age 12. Hours will be 8:30 a.m. until 4:30 p.m. and includes lunch.
CHILD 1 first name
CHILD 1 last name
Enroll CHILD 1 in	Nursery (0-23 months) Preschool (2 yrs -beginning kindergarten) Day Camp (completed kindergarten-age 12)
CHILD 1 Allergies or other medical conditions that require special attention
CHILD 1 Birthdate (mm/dd/yyyy)
Please check	boy girl
For Day Camp, grade for 2008-2009
Please register CHILD 1 for	Two Days Other
If other, please specify
CHILD 2 first name
CHILD 2 last name
Enroll CHILD 2 in	Nursery (0-23 months) Preschool (2 yrs -beginning kindergarten) Day Camp (completed kindergarten-age 12)
CHILD 2 Allergies or other medical conditions that require special attention
CHILD 2 Birthdate (mm/dd/yyyy)
Please check	boy girl
For Day Camp, grade for 2008-2009
Please register CHILD 2 for	Two Days Other
If other, please specify
CHILD 3 first name
CHILD 3 last name
Enroll CHILD 3 in	Nursery (0-23 months) Preschool (2 yrs -beginning kindergarten) Day Camp (completed kindergarten-age 12)
CHILD 3 Allergies or other medical conditions that require special attention
CHILD 3 Birthdate (mm/dd/yyyy)
Please check	boy girl
For Day Camp, grade for 2008-2009
Please register CHILD 3 for	Two Days Other
If other, please specify
Please use another form to enroll additional children.
* Type both words below, separated by a space. Can't read the words below? Try different words or an audio captcha.