Summer Play Camps - 2018 Kindness Corral Divine
Summer Play Camps - 2018 Camp Groups are led by qualified Noah’s Ark Teachers
Age 2 by start of camp through entering 1st grade At Christ the Savior Lutheran Church, 10500 East 126th Street, Fishers, IN 46038
Child’s name: __________________ ___________________ Birth date ____/____/____ Last
First
Address:_________________________ City _____________State ____Zip __________ Home phone: _______________________Primary email: __________________________ Mother’s Name_____________________________ Cell Phone # ___________________ Father’s Name______________________________ Cell Phone #___________________ Addt’l Emergency Name & Cell # ______________________________________________________ Who will pick up the child? Parents? ___ Other?___ If “other” please provide name & phone Name_____________________________ Cell________________ Home ____________ Allergies: ___No __ Yes, explain _____________________________________________ Fears __No __Yes What works to calm the child down:___________________________ Special or learning disabilities: __No __Yes Explain:______________________________ Other concerns: _________________________________________________________ Home church: ___________________________ Would you like a Pastor to call you? Yes/No
Kindness Corral
Divine Discoveries
Age 2 by start of Camp through entering 1st grade Mon., June 11 - Thu., June 14 9:30 a.m. - 1:00 p.m. $85.00 per child Parents Provide Child’s Lunch
Age 2 by start of Camp through entering 1st grade Mon., July 9 - Thu., July 12 9:30 a.m. - 1:00 p.m. $85.00 per child Parents Provide Child’s Lunch
Yes, my child would like to attend _____
Yes, my child would like to attend ____
Please check the weeks you wish your child to attend. You may choose one or both sessions
Payment is required upon registration. Make check payable to Christ the Savior Lutheran Church and put your child’s name on the memo line. There will be a $25 cancellation fee for any cancellation requests made after May 31st. Cancellations must be made in writing in order for us to process a refund. Return completed registration form and payment to Noah’s Ark office or mail to: Christ the Savior Lutheran Church, Attn: Noah’s Ark, 10500 E. 126th Street, Fishers, IN 46038 Child will need to bring a lunch, back pack & extra set of clothes. Diapers & wipes if appropriate. Be sure to send your child in play clothes that can get dirty and with a water bottle. Questions? Call Julie Stocks or Jodi Meehan at 317.288.0314 x240 or email [email protected]
IF STUDENT DID NOT ATTEND NOAH’S ARK PRESCHOOL & KINDERGARTEN FOR THE 2017/2018 SCHOOL YEAR, A MEDICAL CONSENT FORM MUST BE COMPLETED TOO OFFICE USE ONLY
Date Received: __________________
Amount: __________________
Check No.: _______________
Check Date: _______________
Age 2 by start of camp through entering 1st grade At Christ the Savior Lutheran Church, 10500 East 126th Street, Fishers, IN 46038
Child’s name: __________________ ___________________ Birth date ____/____/____ Last
First
Address:_________________________ City _____________State ____Zip __________ Home phone: _______________________Primary email: __________________________ Mother’s Name_____________________________ Cell Phone # ___________________ Father’s Name______________________________ Cell Phone #___________________ Addt’l Emergency Name & Cell # ______________________________________________________ Who will pick up the child? Parents? ___ Other?___ If “other” please provide name & phone Name_____________________________ Cell________________ Home ____________ Allergies: ___No __ Yes, explain _____________________________________________ Fears __No __Yes What works to calm the child down:___________________________ Special or learning disabilities: __No __Yes Explain:______________________________ Other concerns: _________________________________________________________ Home church: ___________________________ Would you like a Pastor to call you? Yes/No
Kindness Corral
Divine Discoveries
Age 2 by start of Camp through entering 1st grade Mon., June 11 - Thu., June 14 9:30 a.m. - 1:00 p.m. $85.00 per child Parents Provide Child’s Lunch
Age 2 by start of Camp through entering 1st grade Mon., July 9 - Thu., July 12 9:30 a.m. - 1:00 p.m. $85.00 per child Parents Provide Child’s Lunch
Yes, my child would like to attend _____
Yes, my child would like to attend ____
Please check the weeks you wish your child to attend. You may choose one or both sessions
Payment is required upon registration. Make check payable to Christ the Savior Lutheran Church and put your child’s name on the memo line. There will be a $25 cancellation fee for any cancellation requests made after May 31st. Cancellations must be made in writing in order for us to process a refund. Return completed registration form and payment to Noah’s Ark office or mail to: Christ the Savior Lutheran Church, Attn: Noah’s Ark, 10500 E. 126th Street, Fishers, IN 46038 Child will need to bring a lunch, back pack & extra set of clothes. Diapers & wipes if appropriate. Be sure to send your child in play clothes that can get dirty and with a water bottle. Questions? Call Julie Stocks or Jodi Meehan at 317.288.0314 x240 or email [email protected]
IF STUDENT DID NOT ATTEND NOAH’S ARK PRESCHOOL & KINDERGARTEN FOR THE 2017/2018 SCHOOL YEAR, A MEDICAL CONSENT FORM MUST BE COMPLETED TOO OFFICE USE ONLY
Date Received: __________________
Amount: __________________
Check No.: _______________
Check Date: _______________
