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PandaPrograms School Day Off Registration for '25-'26 School Year
Thank you for your interest in PandaPrograms Early Release and Days Off School care. All care will take place at Zion Lutheran Church (1501 W. Liberty). Walking Field Trips may occur on any day of care and field trips using AATA buses may occur during full day care programs.

***Please complete this form once per child. If you wish to add additional days, please email us instead of filling out a new form.***

Completing this form does not guarantee enrollment in our program. Please note you must cancel care a minimum of two weeks in advance to get a refund. 

Registration will occur on a rolling basis. Please allow up to 3 days to get confirmation of your child(ren)'s space and an invoice.

Questions? Contact us sarahjesse.pandaprograms@gmail.com
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Email *
Name and Age of Child - form must be completed per child, not per family *
School Attended (Note: if we have a substantial number of campers from a specific school on an Early Release day we will make every effort to provide transportation, if possible) *
Name of Parent/Guardian *
Email Address of Parent/Guardian (for all future program communication) *
Additional Parent/Guardian Email if desired
Phone Number of Parent/Guardian *
Early Release 8/25 *
Early Release 10/31 *
Early Release 3/10 *
Early Release 5/14 *
Day Off: 9/29 *
Day Off: Fall Break 10/10 *
Day Off: Fall Break 10/13 *
Day Off: Election Day 11/4 *
Day Off: MLK Day 1/19 *
Day Off: Mid-Winter Break 2/13 *
Day Off: Mid-Winter Break 2/16 *
Day Off: Mid-Winter Break 2/17 *
Day Off: Election Day 5/5 *
Does your family need a scholarship for the above programs: *
Required
If you were referred by a current PandaFit family please share their name below.
Emergency Contact Name and Phone Number *
Allergies/Medical Information *
Teaching/Intervention Information: How does your student learn best?  Do they have supports or aids at school that would be beneficial for us to know about?
*We will reach out if further information is needed.  We will do our best to accommodate these needs, but may not be able to.
Authorized Pick-Up People (please use first and last name) *
Payment Method (for virtual payment methods you will be contacted with payment details)  *
If you would like to donate to the Scholarship Fund, please let us know how much you'd like to contribute.
Photo Release: PandaPrograms may use images of my child(ren) for the purposes of advertising on their website, social media, and in printed materials. No participant names will be used in connection to images. *
Please contact PandaPrograms with any questions. I am aware of all PandaPrograms activities and allow my child (and at family events, myself) to participate fully unless otherwise noted on this form. I allow and hereby certify that all participants from my family named herein is capable of safely participating in PandaPrograms activities including field trips. I indemnify and hold harmless PandaPrograms, any officer, volunteer or employee of PandaPrograms and all involved with PandaPrograms from liability for any harm that befalls my child or myself as a result of participation in PandaProgram. I consent, unless noted, that photographs and video taken of them at PandaPrograms events may be used and may be reproduced and publicized for program and marketing purposes, free of claims on my part. I agree to allow my child to be transported by PandaPrograms via bus or walking.

I understand the physical activities which my child and/or myself may participate in at PandaProgram Events include, but are not limited to: running, playing and sports. I agree to assume all liability for the risk of injury, illness or death on account of my child’s presence at a PandaProgram's event or on account of my child’s involvement in any activity during an event/program/camp whether caused by negligence of PandaPrograms or another person on the premises or at the sponsored activity.

I give consent to emergency medical and surgical treatment of the camper and minor staff person and to
routine, nonsurgical medical care. If there is religious objection to consenting to receipt of emergency medical or surgical treatment, the authorized person must submit a written statement to the effect that the camper is in good health and that the person signing assumes the health responsibility for the camper.

I have read and understand PandaPrograms' behavioral expectations.
*
A copy of your responses will be emailed to the address you provided.
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