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 "The Wonderful World of Art"                                              June 13-17:  Mon - Fri   9:00 AM - 3:00 PM
Requirements: Must be two years old by March 31, 2022 through those who have completed kindergarten. Two year olds must be independently walking and eating. Three year olds must be potty trained.
Please submit your $295 Summerfest tuition by check or by Zelle at chumsschool@gmail.com
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Child's First Name *
Child's Last Name *
Child's Age *
Child's Birthdate *
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Email *
Parent's Name *
Mother's Cell *
Mother's Work Phone
Father's Cell *
Father's Work Phone
Address *
Please list any medical problems, allergies, or behavioral patterns that may require special attention.
Please list 1st person (not including the child's parents) to contact in case of accident or illness. Include name and phone number. *
Please list 2nd person (not including the child's parents) to contact in case of accident or illness. Include name and phone number. *
By entering your name below, I certify that my child has had a physical exam by a physician within the last year and is able to participate fully in the Summerfest program. My child's immunizations are current and up to date. Children new to CHUMS will need to provide a current immunization record. *
By entering your name below you authorize the following: EMERGENCY MEDICAL AUTHORIZATION: In the event that I cannot be reached to make arrangements for emergency medical attention at the time of illness or accident, I hereby authorize the staff of CHUMS to call EMS or take my child to the nearest hospital. *
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