Living Spanish Summer Camp in Palo Alto 2018
Registration

To register, simply fill out this form and mail the tuition check to Learnika at 572 College Ave, Palo Alto, CA 94306.

$395 per weekly session for whole day, 9:00 AM - 2:30 PM
$315 for weekly session for 1/2 day, 9:00 AM - 12:00 Noon

5% discount for signing up for 3 or more sessions.

Camper's Name *
Your answer
Date of Birth (mm/dd/yyyy) *
Your answer
Entering Grade for Fall 2018 *
Your answer
School *
Your answer
Parents' Names *
Your answer
Address *
Your answer
Email Address: *
Your answer
Contact Number *
Your answer
Attending Session *
Required
Specific Health Information
Instructions on medication needs, allergies, and other important information. Please include the name of the Camper.
Your answer
Extended Care
Extended care ($15/hr) available 8:00 - 9:00am and 2:30-5:30pm. Prompt arrival and pick-up are greatly appreciated. Please note that campers who arrive before 8:50am and remain after 2:45pm are placed into extended care and are duly charged.
Parent / Guardian Permission
I/we hereby give consent for the above camper to participate in the Living Spanish Summer Camp program for the 2017 season. I/we are aware that our child will be involved in the normal hazards of summer camp activities. In consideration of acceptance of this application, intending to be legally bound, hereby, for ourselves, our heirs, executors and administrators, waive and release all rights and claims that may arise against Living Spanish Camp, and any person affiliated with this camp. I/we further attest that the camper is physically fit and has been examined by a physician. I/we give permission to the Living Spanish staff and Natalia de la Chica to provide and approve immediate and responsible emergency care and transportation should it be required. Every attempt will be made to notify parent/guardian. I/we grant permission for prescribed medications to be administered while at camp and for routine health care to be administered. I/we understand that by signing this document, I/we am releasing Living Spanish organization and Natalia de la Chica from any and all liability for personal injury, including physical, emotional, pain, and suffering injuries and/or property loss and damage which my children incurs as a result of participation in the Living Spanish Summer Camp. Living Spanish reserves the right to dismiss campers without refund if either camper or parents interfere with the smooth operation of the camp program. I hereby grant Living Spanish full rights to copyright, exhibit, and publish in any medium including, but not limited to, editorial illustration, promotion, advertising, Internet, or trade all photographs taken by Living Spanish and its staffs of my child at Living Spanish program.
Enter Electronic Signature
Please type your name in the box below:
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms