The Spot School's Out Camp Enrollment 24-25 - Form

CHILD INFORMATION

* First Name

* Last Name

* Date of Birth

* Gender

* Pronouns

Gender/Pronoun Other Selection

If you selected Other for either Gender or Pronoun, please write your child's preferences here.

* My child is enrolled in The Spot After-School Program

Please Select OneYesNo

ENROLLMENT INFORMATION

* Fall 2024 Elementary School

My child will be attending the following school in 2024-2025

If you chose other, which school does your child attend?

Please note, parents/guardians are responsible for transportation to and from The Spot on School's Out Camp days.

PARENT INFORMATION

* Parent 1 First Name

* Parent 1 Last Name

* Parent 1 Email

* Parent 1 Phone

Parent 1 Occupation

* Address

* City

* State

* Zip Code

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Phone

Parent 2 Occupation

Parent 2 Relationship to Child

Address (if different from address above)

EMERGENCY CONTACT INFORMATION

* First Name

* Last Name

* Email

* Phone

* Relationship to Child

* First Name

* Last Name

* Email

* Phone

* Relationship to Child

ADDITIONAL AUTHORIZED PICK-UP

Other than the two parents/guardians listed above, please provide two other adults authorized to pick up your child.

AUTHORIZED PICK-UP PERSON #1

* First Name

* Last Name

* Email

* Phone

* Relationship to Child

AUTHORIZED PICK-UP PERSON #2

* First Name

* Last Name

* Email

* Phone

* Relationship to Child

If your child is not enrolled in The Spot After-School Program and you sign up for 15 or more School's Out Camp days, you will qualify for a discount rate of $100 per day.
If your child is enrolled in the Spot After-School Program and you sign up for 15 or more School's Out Camp days, you will qualify for a discount rate of $90 per day.
This discount will be in the form of a refund of the cost difference. It may take up to 2 weeks for the refund to be applied to your account.

Total