Free Horizon Montessori 2018 Summer Camp Enrollment Form
Please complete a separate Enrollment Form for each child. A $50 non-refundable deposit is required for each week long session at the time of enrollment, which applies to the total camp cost. . No invoices for balances owed will be sent, so please mark your calendar accordingly. The deadline for enrollment is May 22.

Please forward me the confirmation email with your recorded form responses or add my email on the top of form ( Valid Email address) so I can receive your responses to keep for our school records. Thank you!

Email address *
Parent/Guardian Email *
Your answer
Camper's Last Name (child's) *
Your answer
Camper's First Name (Child's) *
Your answer
Age *
Your answer
Date of Birth *
Child's Grade in Fall 2018? *
Your answer
School attending in Fall of 2018 *
Your answer
Jeffco Schools Student ID Number (if applicable, if not put N/A) *
Your answer
Please list any health concerns/Allergies: *
Your answer
Parent/Guardian Name *
Your answer
Does this student have a sibling? If so who?
Your answer
Parent/Guardian Phone (during camp hours) *
Your answer
Are you an employee of Free Horizon Montessori *
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Enrollment and Fees
Fees include all program materials, field trips, transportation, enrichment activities, and snacks (when applicable). Please contact Millie Lippert, Program Director, at . For detailed camp descriptions and more information, please visit our website at Please check appropriate boxes in order to enroll for desired sessions. All 3-day programming runa Tuesday, Wednesday and Thursday, except the week of July 4th, which will run Tuesday & Thursday (Wednesday no camp) Sessions 7 is operated by Sticky Fingers and Lil Kicker Soccer at FHM.
FHM Session 1 (June 11-15th): Bug’s Life Week *
FHM Session 2 (June 18-22th): Ooey Gooey Week *
FHM Session 3 (June 25-29rd): Under the Sea/Splash-tastic Week *
FHM Session 4 (July 2-6): Patriotic Week (M, Tues,Thurs, Fri) NO CAMP WEDNESDAY *
FHM Session 5 (July 9-13):Fun and Fitness Week *
FHM Session 6 (July 16-20): FHM's Got Talent Week *
Middle School Summer Camp: Counselors in Training
FHM is seeking mature, energetic Middle and High School students who enjoy spending time with young children to apply as “Counselors in Training” for our 2018 Summer Camp program. Students applying for this position must:
- Be between the ages of 11 years and 15 years
- Be entering 7th grade or higher
- Be in good standing with Free Horizon Montessori (or current school) and Jeffco School District
- Show evidence of demonstrated respect for others, self and environment by providing at least one (1) letter of recommendation from a teacher or other school staff (for homeschooled students, a letter from a non-family community member is also acceptable)
- Write a short (2-4 paragraph) essay about why the student would like to be a “Counselor in Training” at FHM
- Participate in an in-person interview with FHM staff
- Submit the attached enrollment form and all registration paperwork, as required by FHM, on or before the deadline
Students accepted into the Counselor in Training program will assist Camp Counselors in many areas of Camp Programming, including (but not limited to):
- Engaging with campers in games and activities
- Leading small group activities under the supervision of Counselors
- Preparing the classroom for the day (setting up materials, obstacle courses, etc.)
- Preparing materials for the campers (cutting, measuring, etc.)
- Ensuring campers are safe and rules are being followed
- Small “household” type cleaning tasks (loading the dishwasher, wiping down tables)
Counselors in Training (CiT’s) are still considered “campers” under our child care license, and must be under the supervision of a Counselor at all times. CiT’s will not be left alone with children, will not provide discipline (beyond basic classroom management), and will not be able to travel out of hearing distance of FHM staff. The CiT program is a learning opportunity for our oldest students, and we expect to provide CiT’s with guidance and instruction as part of their daily activities.
There is a $50 weekly fee for the CiT program. This fee covers the cost of the CiT’s spot in the program, including partial coverage for field trips, transportation, and activity materials. All CiT’s must commit to at least one full session, and must attend Counselor Training (date TBA, week of June 5th).
For further questions, or to apply, please contact Ms. Millie Lippert, Program & Enrollment Coordinator, at or 303-231-9801, ext. 241.
Thank you for your interest in the Counselor in Training Program at Free Horizon Montessori School’s Summer Camp!
My Middle Schooler will participate in the following sessions. *
Session 7 Enrichment Program Summer Camp
For these two enrichment summer programs mentioned below, please contact the instructor directly for registration , more Info in regards to these summer programs can be found on our website. This form does not act as a registration form for these outside programs.
Session *
Payment Information
A $50 non-refundable deposit is required at the time of enrollment for each weeklong session. Balance is due May 1st for Sessions 1 – 5 and May 15th for Sessions 6-7. If enrolling on or after May 15th, complete payment is due at the time of registration. Because staff hiring is based on enrollment and we must secure field trip, transportation, and enrichment reservations well in advance, all fees are retained if the child is withdrawn from the program unless a written cancellation is received by 3:30 pm on Thursday, April 27th, 2017. Cancellations made after this date will not receive a refund. The $50/week deposit is non-refundable and retained regardless of withdrawal notice or date. Adjustments in schedule must be made in writing and are subject to availability. Each change made after April 27th, 2017, will incur a $25 Change Fee. Payments received over 5 days late will incur a $30 Late Fee. Returned checks incur a $50 fee. There are no refunds or deductions if a child misses for any reason, including illness, vacation, or discipline. Registration forms, including medical history and immunization information, will be sent via email to the address provided in the parent/guardian information section and are due back no later than May 15th. Please make arrangements to have an up to date Immunization Record and Annual Statement of Heath prepared by May 15th; this may require a physician’s office visit. We WILL accept the physician’s office version of both the Immunization Record and Annual Statement of Heath, but require NEW forms for ALL CAMPERS. FHM does not retain health forms.FHM accepts Visa, Master Card, Discover, checks, and cash. Payments may be made in person during regular office hours of 7:45 am – 3:45 pm Monday – Friday during the regular school year, or sent through the postal mail. Please do not send cash through the mail. Note that the office will be closed March 24th-April 3rd. Payments may also be made through Jeffco Connect for FHM students only. The district shuts down Jeffco Connect for annual maintenance in June, so all payments must be made by May 15th to ensure timely processing
Payment Option Request *
CAMP Late pick-up
Children not picked up by the end of the session for which they are registered incur a charge of $1.00 per minute; payable within 24 hours of the late pickup. In the event that your child is not picked up within a half hour past the end of their selected program, and the parents/guardians cannot be reached, our licensing policies require us to notify the emergency contacts you have listed. If no one is able to pick up your child within an hour past the end of their selected program, we must then call the Jefferson County Sheriff’s Department and Social Services, who will assume custody of the child.
My Signature
I have read and understand the above guidelines. I agree to uphold the guidelines and understand that if the balance is not paid by the due date(s), my deposit and space will be forfeited. Further, I understand that my child cannot stay at camp until all required enrollment, health, and emergency forms are submitted.(when you type your name it will act as your signature)
Parent /Guardian Electronic Signature *
Your answer
Today's Date *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Jefferson County Public Schools. Report Abuse - Terms of Service - Additional Terms