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School Age Summer Camp Registration Form 2019
Complete form and send in a $50 non-refundable registration fee to ACPC Main Center (920 Carroll Avenue). If you choose to withdraw your child or change their enrollment, a reduction of fees for the month will be given if a two week notice is given.
Email address *
Child's Name: *
Your answer
What grade is your child going into Fall 2019? *
Parent/Guardian Name(s): *
Your answer
Parent/Guardian email address *
Your answer
Child's T-shirt Size *
June 7-August 2 : Do you want to register your child for Full Time (Monday-Friday) or Part Time? If registering for this option, DO NOT complete the next question.
If you registered for Full Time or Part Time above, DO NOT COMPLETE this section. June 10-August 2 Weekly Option: What weeks do you want to register your child for?
August 5-16 Extended Care for Full Time or Part Time Families. If you registering for the weekly option, your child can not attend these two weeks. $200/per week, $150 3 days/week, $100 2 days/week *
ACPC offers Reduced Fees through ASSET & DHS Child Care Assistance to families that qualify. See ACPC website ( for required documentation. If eligible are you interested in utilizing ASSET or DHS?
A copy of your responses will be emailed to the address you provided.
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