“Quality Education in the LIGHT of God’s Word”

SUMMER ENRICHMENT REGISTRATION K5 – 8TH GRADE

STUDENT’S FULL LEGAL NAME(Required)
Gender
Current Address(Required)

BIOLOGICAL/ADOPTIVE PARENT INFORMATION

FATHER’S LEGAL NAME(Required)
APPLICANT LIVES WITH

MOTHER'S LEGAL NAME(Required)
APPLICANT LIVES WITH

STEP-PARENT, GUARDIAN INFORMATION IF APPLICABLE

NAME
APPLICANT LIVES WITH

NAME
APPLICANT LIVES WITH

2026 Summer Camp Rates

FIRST PAYMENT DUE DATE $100 5/15/26
SECOND PAYMENT DUE DATE $300 6/12/26
AFTER CARE BILLED WEEKLY $6 / 30 minutes