Summer Camp Registration at Ivy School
Use this form to enroll your child in Summer Camp at the Ivy School for 2020.
Email address *
General Information and Overview
Information and Overview are located at https://www.theivyschool.org/summer-camp

Each week-long camp is $330 per student.
Student Last Name *
Your answer
Student First Name *
Your answer
Student's Age *
Student's Birth Date *
MM
/
DD
/
YYYY
Summer Sessions (Please select the sessions you wish to enroll your child in) *
Information and Overview are located at https://www.theivyschool.org/summer-camp Each week-long camp is $330 per student.
Required
I wish to enroll my child in Before Camp Care for selected sessions. *
Please provide your child’s medical information below:
Medical Insurance Provider *
Your answer
Group # *
Your answer
Member # *
Your answer
Preferred Hospital: *
Your answer
Please list any food or environmental allergies (including severity) or medical conditions your child has: *
Your answer
Emergency Contacts: We require two emergency contacts who are not parents
Emergency Contact # 1 Name (First and Last) *
Your answer
Emergency Contact # 1 Phone Number *
Your answer
Emergency Contact # 2 Name (First and Last) *
Your answer
Emergency Contact # 2 Phone Number *
Your answer
Please provide any other information you would like us to know about your child: *
Your answer
2020 Ivy Summer Camp Agreement Section
I am enrolling my student, named above, in the 2020 Ivy Summer Camp. I agree to the following (please check each one): *
Required
Please choose a 10% discount if applicable. Discounts may NOT be combined. *
I agree with all policies stated above and agree to abide by them. *
Your answer
Please input the full names of all responsible parties. Contracts must be complete before we can accept your child into our program. Contracts must be initialed by all financially responsible parties. It is the responsibility of the parties to divide cost/ payments between split households.
Full Name(s) all financially responsible parties *
Your answer
Initials of all financially responsible parties *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of The Ivy School. Report Abuse