FOUNDATIONS: Early Childhood Literacy Camp, Summer 2022
Event Timing: Summer 2022
Location:  Bellaire United Methodist Church, 4417 Bellaire BLVD.
Instructor: Sarah Baker Suminski
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Email *
Student's Last Name *
Student's First Name *
Student's Birth Date *
Student's Age as of September 1, 2022 *
Current School of Enrollment *
Current Grade of Enrollment *
Parent/Guardian 1 Name *
Parent/Guardian 1 Contact Number *
Parent email address 1 *
Parent/Guardian Name 2
Parent contact number 2
Parent email address 2
Emergency Contact Name *
Emergency Contact Number *
Individuals authorized to pick up your child, in addition to named parents/guardians
Physician's Name *
Physician's Contact Number *
Insurance Company *
Insurance Policy Number *
Consent for Medical Emergency Treatment
In the event I cannot be contacted during a medical emergency, I give permission for my child to be transported by ambulance to Texas Children's Hospital or other medical emergency center for treatment. I further consent to the disclosure of health information and to the medical, surgical and hospital care treatment and procedures (including, but not limited to, administration of necessary anesthetics, tests, x-ray examinations, transfusions, injections, drugs) to be performed for my child by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my child’s health.
Release from Liability:  Recognizing that staff will provide constant supervision and will do their best to ensure a safe experience, I understand that accidents may occur from my child’s participation in program activities. By checking this box, I agree to assume this risk and release staff from all liability. *
Photo Release: The applicant hereby gives permission for Foundations to use, without limitation or obligation, photographs or other media that may include the members’ image for training purposes, to promote educational programs, as well as on our private camp sharesite for clients only. *
Early Childhood Literacy Summer Camp                                                                                                                                                                                    This educational camp will address all developmental domains through fun thematic units, hands-on learning centers, opportunities for creativity, oral language development and play, as well as research-based explicit early literacy instruction.  Targeting children entering kindergarten, turning age 5 on or before September 1, 2022.  Each session will be held Monday through Friday, 9:00 am - 12:00 pm.  Which session(s) will your child attend?  Please indicate below.
Please Indicate below
Session 1                                                                                                                                                                                                                                                           July 11  - July 15                                                                                                                                                                                 Theme: Let's Go Camping!                                                                                  
Session 2                                                                                                                                                                                                July 18 -July 22                                                                                                                                                                                                Theme: How Does Your Garden Grow?
Session 3 - FULL                                                                                                                                                                                           July 25 - July 29                                                                                                                                                                           Theme: All About Pets!                                                                  
Session 4 - FULL                                                                                                                                                                                              August 1  - August 5                                                                                                                                                                   Theme: Space Exploration!
Camp Tuition: $375 per session due on or before May 31, 2022.  Registration Fee: $50 non-refundable registration fee per session is due at time of registration to hold your child's space in camp.  This fee will be credited towards your final tuition balance.   Your registration will not be complete until the registration fee is paid in full.  There will be no refunds after May 31st.  Tuition not paid on or before May 31st will result in an incomplete registration; therefore opening the space up for another camper.    Invoicing is done through Quickbooks and will be emailed to the email address provided at the time of registration.  Payments may be made via Venmo or personal check. *
The goal of Foundations for Learning Success is to lay a strong foundation for literacy success and develop a love of learning.  We offer developmentally appropriate research-based early literacy instruction.  Foundations Early Literacy Summer Camp hours of operation are 9:00-12:00pm.  Before and after school care are not available through Foundations, as we are not a childcare facility and not licensed by the state as such.  Foundations for Learning Success has been exempted from Child Care Licensing through an application process through the Texas Department of Health and Human Services.  (Operation #1734352)   *
Current Covid Policy and Procedures:(Subject to Change: Any changes in policies and procedures will be shared with you prior to the onset of camp.)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    -Upon entering the classroom, student's will clean hands with provided hand sanitizer.                                                                                                                                                                                                                                                        -Shared manipulatives will be sanitized daily.                                                                                    -Surfaces will be sanitized between every class.                                                                                                      -Students will not be required to wear masks, but may wear them per parent choice.                                                                 -Teachers will not be required to wear masks.                                                                                                                                                                                                                                                                                                                                                                                                                                             *
How did you hear about us?  Please check all that apply.  We would greatly appreciate your input!  Thank you! *
A copy of your responses will be emailed to the address you provided.
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