At Building Blocks Prep
Program is open to children pre-school age through 3rd grade.
Get ready for 4 days of winter fun.
Snow activities, science experiments, art projects and much, much more.
Snow clothing required everyday of camp.
There is a $20.00 registration fee ($30.00 for a family registration). Space is limited. Registration is due by February 10th to secure your spot.
Payment is due in full on the first day of camp. Staffing is based on camp registration, therefore any change, withdrawal or absence from the program will still require full payment.
Registration:
|
February 21st |
8:30-1:00 $30.00____ |
7-4:00 $41.00____ 7-5:00 $45.00____ |
|
February 22nd |
8:30-1:00 $30.00____ |
7-4:00 $41.00____ 7-5:00 $45.00____ |
|
February 23rd |
8:30-1:00 $30.00____ |
7-4:00 $41.00____ 7-5:00 $45.00____ |
|
February 24th |
8:30-1:00 $30.00____ Pizza $4.00_____ |
7-4:00 $41.00____ 7-5:00 $45.00____ Pizza $4.00____
|
|
Total $______________ |
Total $_________ |
Children should dress according to the weather, we do go outside everyday. A full change of clothes is needed. We happily provide snack but parents supply Lunch each day. Children staying all day should bring a small blanket.
Registration Form
Child’s Name_______________________________D.O.B.______________________
Child’s Address:_________________________________________________________
Street City State Zip
Mother/Guardian Name:________________________________________________
Home Phone:________________________ Cell Phone:_________________________
Employed By:________________________ Phone:____________________________
Father/Guardian Name:________________________________________________
Home Phone:_________________________ Cell Phone:________________________
Employed By:_________________________ Phone:___________________________
Emergency Contact (other than Parent):
Name:______________________________ Relationship:________________________
Home Phone:_________________________ Cell Phone:_________________________
Medical History
: (List) If there are any special concerns, please discuss with staff.______________________________________________________________________
______________________________________________________________________
Allergies: (List) If there are any special concerns, please discuss with staff.
______________________________________________________________________
______________________________________________________________________
Emergency Medical Treatment:
I hereby give Building Blocks Prep permission to administer first aid and/or CPR to my child and/or take my child to a hospital and to secure medical treatment when I cannot be reached or when delay would be dangerous to my child’s health.
_______________________________ ______________________________________
Parent/Guardian Signature Date
We must have a recent physical and immunization on record, (no longer than 1 year). This may be obtained through your doctor’s office. A child will not be admitted without one.
Physical on file______ Will provide physical/immunization_____
I agree to all of the terms and conditions stated above and in the Policies and Procedures of Building Blocks Prep.
_______________________________ ________________________________
Parent/Guardian Signature Date