Little Folks Summer Camp 2021 Application

Child's Name *

Sex

Male

Female

Child's Birthdate *

Address *

City *

State *

Zip Code *

Phone *

Parent Name *

Email *

Work Phone

Cell Phone

Parent Name

Work Phone

Cell Phone

IN CASE OF EMERGENCY

Please provide 2 contacts who are authorized to pick up your child, one should live in the Georgetown area.

Name

Home Phone

Work Phone

Cell Phone

Relationship

Name

Home Phone

Work Phone

Cell Phone

Relationship

Allergies or other health factors we should be aware of

Please check the session that you are applying for:

FULL SUMMER - Morning Only Program $3,265

FULL SUMMER - Full Day Session** $4,101

Session 1: June 7 - July 2 - Full Day Session** - $2,100

Session 1: June 7 - July 2 - Morning Only Session** - $1,680

Session 2: July 5 - July 30 - Full Day Session** - $2,100

Session 2: July 5 - July 30 - Morning Only Session** - $1,680

Application Fee & Deposit* $500

Tuition and application fees are not refundable. There are no refunds for absences.
*To be applied towards tuition
**Lunch included 2 days per week

Tuition must be paid in full by May 1, 2021

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