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Kids Summer Program 2026
Program Starts June 22, 2026-July 30, 2026 Tuesday, Wednesday,
Thursday 9:00am-5:00pm
Contact us: Monica Sanchez: 323-595-3013 monica.sanchez@esrbc.org
Jennifer Arceo: 323-716-8343 jennifer.arceo@esrbc.org
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1. Participant Name & Date of Birth
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Your answer
2. Participant Name & Date of Birth
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Your answer
3. Participant Name & Date of Birth
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Your answer
Parent Name:
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Your answer
Home Address:
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Contact Number:
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Your answer
Email
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Emergency Contact Number:
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Any Allergies:
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How did you hear about the program:
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What days will you attend?
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Huntington Park
Tuesday
Wednesday
Thursday
Required
****Parents must be present at the center to fill out and turn in
the intake forms****
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