Birthdate_________PreK completed T 2 3 4 5 Circle Classroom Address__________________________________________________________________ (Street) (City) (State) (Zip) Allergies (Food & Environmental)__________________
Epipen or Inhaler_____________________
Father’s Name_____________________
Mother’s Name_______________________
Contact Phone_____________________
Contact Phone_______________________
Work Phone_______________________
Work Phone_________________________
Email Address______________________
Email Address________________________
$50 nonrefundable deposit per camp required at the time of registration. Deposit will be applied to tuition June 4 – 8 * Super Spy
9:30-2:30________$135
7:30-5:45________$185
June 11 – 15 * Cool Chemistry
9:30-2:30________$135
7:30-5:45________$185
June 18 – 22 * Closed for Vacation Bible School June 25 – 29 * Awesome Art
9:30-2:30________$135
7:30-5:45________$185
July 2 – July 6 * U*S*A (Closed July 4th) 9:30-2:30________$110
7:30-5:45________$160
July 9 – 13 * Sea World
7:30-5:45________$185
9:30-2:30________$135
July 16 – 20 * Closed for Lutheran Education Conference July 23 – 27 * Whiz Kids in the Kitchen
9:30-2:30________$135
7:30-5:45________$185
July 30 – August 3 * Circus Carnival
9:30-2:30________$135
7:30-5:45________$185
August 6 – 10 * Closed for Teacher In-Service, Training, and Back to School Night Preparations. Students new to Faith Lutheran Preschool must provide a shot record and all necessary information forms by May 15. All tuition payments are nonrefundable. Tuition (minus the deposit) due the first day of camp. _________________________________________ Parent/Guardian Signature