Summer Camp Enrollment

Apply online to Riverbend Montessori School’s Summer Camp

Summer Camp Enrollment Form: 2023

1General

2Consent

3Sessions

4Financial Agreement

Student Information
Enrollment Type*
- New Student
- Current Student
Child’s Full Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Age on 9/1/2023*
Gender*
Race*
Address*
Street Address City State ZIP Code
Number of Guardians*
How many parents or legal guardians does this child have?
- 1
- 2
Guardian 1 Information
Guardian 1 Relationship*
- Father
- Mother
- Legal Guardian
Guardian 1 Name*
First Last
Guardian 1 Occupation & Employer*
Guardian 1 Business Phone*
Guardian 1 Cell Phone*
Guardian 1 Email*
Guardian 2 Information
Guardian 2 Relationship*
- Father
- Mother
- Legal Guardian
Guardian 2 Name*
First Last
Guardian 2 Occupation & Employer*
Guardian 2 Business Phone*
Guardian 2 Cell Phone*
Guardian 2 Email*

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Consent
Snacks*
I understand that AM and PM snacks may be served to my child while in care. Parents will be required to provide two snacks per day for their children. Additional snacks may be provided by the school.
I Understand
Friday Lunch
I understand that Cheese Pizza will be served to my child for Friday Lunch. (FULL DAY ONLY)
I Understand
Water Activities*
Includes sprinkler play, splashing / wading pools, water table play
- I hereby give consent for my child to participate in Water Activities
- I do not give consent for my child to participate in Water Activities

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Sessions
Pick a Session
May 30 - July 21
- Half Days Entire Summer, 9am - 12pm ($1,780)
- Full Days Entire Summer, 9am - 3pm ($2,120)
- Choose Individual Week(s)
Before & After Care - Entire Summer
Before and After Care is available for the entire Summer or on a weekly basis.
- Week 1
  May 30-02 June | Ocean Animals
- Before & After Care Week 1
- Week 2
  June 5 - 9 | Insects
- Before & After Care Week 2
- Week 3
  June 12 - 16 | Exploring Lego
- Before & After Care Week 3
- Week 4
  June 19 - 23 | Cooking
- Before & After Care Week 4
- Week 5
  June 26 - June 30 | Children of the World
- Before & After Care Week 5
- (no camp on week 6)
- Week 7
  July 10 - 14 | Explore China
- Before & After Care Week 7
- Week 8
  July 17 - 21 | Theatre
- Before & After Care Week 8
- Total
  $0.00

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Financial Agreement
Financial Agreement
- All deposits are due no later than March 20, 2023. Deposits are non-refundable. You will be invoiced electronically.
- I understand the balance of Summer Camp Tuition will be due on April 24, 2023. Once this is paid, tuition becomes non-refundable
- I agree that I am responsible for tuition, before care, and aftercare payments for the entire week(s), regardless of the number of days absent.
- AFTER CARE: I understand that I will be charged $1 per minute for late fee pick up after 4:30 pm.
- I understand that minimum enrollment numbers are required. If we do not meet numbers for a particular week, the camp will be canceled and you will be refunded the relevant tuition for that period.
- I understand that up until May 15, 2023 Summer Camp selections may be substituted for other weeks, if a vacancy is available. After this date, no changes will be permitted.
- I understand that a fee of $35 will be charged on all returned checks.
- I understand that a $10 late pick-up fee will be assessed after the last car in the line has left for half-day students. Full-day students will be charged the after-school care fee after the last car in the lineup has left.
- Financial Agreement*
  - I understand and agree that I am responsible for the entire payment of weeks selected, regardless of the number of days absent. Summer Camp fees are non refundable after the final balance payment is made.
- Guardian Signature*
- Name
  This field is for validation purposes and should be left unchanged.