Summer Camp Online Enrollment Form
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Student's Infomation
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Full Legal Name *
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If student has a middle name, it can be entered in the "Last" field
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Preferred Name
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Gender *
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Female
Male
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Birth Date *
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MM
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DD
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YYYY
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Student's Current Age *
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Is English the Student's primary language? *
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Yes
No
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If no, please specify.
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Language
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Home Phone Number *
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Parents / Legal Guardian Names and Home Address
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Parent A/ Legal Guardian Full Legal Name *
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Please indicate Mr., Mrs., Ms., etc.,
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Parent A / Legal Guardian Cell Phone Number *
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Parent A/ Legal Guardian Email Address *
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Parent B/ Legal Guardian Full Legal Name *
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Please indicate Mr., Mrs., Ms., etc.,
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Parent B /Legal Guardian Cell Phone Number *
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Parent B/ Legal Guardian Email Address
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Address *
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Each session last two weeks. Children can
attend only one of the two weeks in each session and alternate their
weeks if desired. There will be different
activities related to each theme weekly at at every session.
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Is student attending Full or Half Day Session(s)? *
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Half Day
Full Day
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Camp Sessions *
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Group Age 2
1/2
Session 1: June 18th – 22nd Agua y Ciencia (Part 1)
Session 2: June 25th – 29th Agua y Ciencia (Part 2)
Session 3: July 2nd - 6th Viajando al Espacio (Part 1) No camp on July 4th
Session 4: July 9th - 13th Viajando al Espacio (Part 2)
Session 5: July 16th - 20th El Circo (Part 1)
Session 6: July 23rd - 27th El Circo (Part 2)
Session 7: July 30th - August 3rd El Arte y El Espíritu Emprendedor (Part 1)
Session 8: August 6th - 10th El Arte y El Espíritu Emprendedor (Part 2)
Session 9: August 13th - 17th Ciencia, Causa, y Efecto (Part 1)
Session 10: August 20th - 24th Ciencia, Causa, y Efecto (Part 2)
Session 11: August 27th - 29th Ciencia y Comida (3 days camp)
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Will you need Morning Extended Hours? *
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Yes
No
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Will you need Afternoon Extended Hours? *
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Yes
No
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Location of Interest *
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Burlingame (We only accept children ages 3 ½ - 12 years old)
San Mateo - Alameda de las Pulgas (We accept children ages 2 ½ - 12 years old)
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Medical Information
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Student's Doctor *
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Doctor's Phone Number *
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Medical Conditions / Concerns *
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Medications/ Allergies *
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Health Insurance and Policy Number *
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Emergency Contact
It must be someone who is available and can be easily reach. DO NOT list parents in the spaces below.
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Full Name *
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Address *
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Phone Number *
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Model Release
I understand that Welcome Amigos has full
copyright of all images taken of me, my family, and/or my children and
that they may use any said image for samples,
brochures, website, and any other legal form of advertisement that
Welcome Amigos utilizes for marketing purposes. I understand that the
Welcome Amigos program director may attempt to
notify me and determined any use of image taken of me, my family,
and/or my children. I also understand that there will be no
compensation made to me, my family, my children, or anyone who
may choose to represent me for the use of said images. I hereby agree
to all terms of this model release.
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Please indicate *
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I agree
I disagree
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Parents/ Legal Guardian's Initial
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Parents/ Legal Guardian's Permission
As legal guardian/parent, I give my permission for this child to attend the Welcome Amigos Spanish Immersion Summer Camp 2012.
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Today's Date *
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MM
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DD
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YYYY
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Parents/ Legal Guardian's Initial *
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TUITION POLICIES
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- Full Payment is due at the time of enrollment when signing up for weekly camp session/s
- If you are signing up for the 3 days a week option for the whole
summer, we require half of your total tuition by March 15th, 2012
- If you are signing up for multiple sessions and need to make tuition arrangements, please send us an e-mail at:
info@welcomeamigos.com
- We accept payments by check only*
please write your child's name on the check*
- Checks should be made/sent to: Welcome Amigos. 1737 Hamlet St. San Mateo, Ca. 94403.
- Changing camp dates:If you want to change the camp schedule after your child is already enrolled, we will try to accommodate
him/her if space allows
- There is a$150.00 non-refundable fee applicable to your tuition if
you cancel any camp session by June 8th, 2012. No refunds after
June 13th, 2012.
- We will send out a confirmation letter once we received your online registration and tuition. Gracias!
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Comment Box
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