ENCORE Summer Experience 2019
Price: $175/week
Sibling Rate: $150/week per sibling
Venue: CedarBridge Academy
Age: 5-12 (must have completed P1)

Cancellation/Refund Policy
Cancellation refunds will be given, less deposit fee, when such notice is received no less than 7 days prior to the child’s expected start date.

Email address *
Camper's Full Name *
Last Name, First Name
Your answer
Select which week(s) your child will attend *
Select an elective *
Select a second elective *
Will your child take part in our Extended Encore Experience (E3)? Additional $25/week (3:30-5:30pm) Latest pick up is at 5:30pm *
Gender *
T-shirt Size *
Child's Current Age *
Your answer
Date of Birth *
School *
Your answer
Year Level Completed in June 2019 *
Parent/Guardian Name(s) *
Your answer
Work Phone
Your answer
Cell Phone *
Your answer
Best way to contact you? *
Has your child had any prior experience with coding? *
How will your child get home? *
Car riders: Who will pick up your child? Bus riders: Which bus route/number? Walkers: Where will they walk? *
Your answer
My child has permission to swim: (If yes, please describe your child’s swimming ability below) *
Does your child have any medications, allergies, special needs or learning challenges? If so please specify... *
Your answer
Child's Pediatrician & Contact Number *
Your answer
Emergency Contact - Relationship - Phone Number *
Your answer
Choose your method of payment ($50 deposit due with registration, the balance is due 2 weeks prior to your child's start date) *
Credit/Debit Card Number, Expiration Date, CVV, Postal Code
Your answer
How did you hear about ENCORE Summer Experience? *
Additional Information
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service