JOHNSTON SUMMER CAMP 2024
Please READ CAREFULLY and complete this registration form entirely. Failure to complete this registration form accurately could cause registration delay and/or loss of your child's summer camp spot. Campers must be a currently enrolled or accepted (incoming) Kindergarten-8th grade student of Johnston Charter Academy. Select which weeks of summer camp you would like for your child to attend. Select "ALL 6 WEEKS" if you'd like your child to attend EVERY week. Select the specific program (time/rate) you wish to sign up for.  A Confirmation email and invoice will be emailed within 24-48 hours after submitting this form. 
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#1 Parent/Guardian First and Last Name
 *
#1 Parent/Guardian Contact Phone Number  *
Primary Email address *
#2-Parent/Guardian First and Last Name
#2 Parent/Guardian Contact Phone Number 
Secondary Email address
Camper # 1:  First/Last Name  *
Camper #1: Grade Level (Current) *
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Check one
Camper #1: Dietary Restrictions? *
None
Vegetarian
Vegan
Gluten-free
Red 40
Other
Check all that apply
Does your child take medications? If so, please medications he/she takes *
Camper # 2:  First/Last Name 
Camper #2: Grade Level (Current)
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Check one
Clear selection
Camper #2: Dietary Restrictions?
None
Vegetarian
Vegan
Gluten-free
Red 40
Other
Check all that apply
Does your child take medications? If so, please medications he/she takes
Camper # 3:  First/Last Name 
Camper #3: Grade Level (Current)
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Check one
Clear selection
Camper #3: Dietary Restrictions?
None
Vegetarian
Vegan
Gluten-free
Red 40
Other
Check all that apply
Does your child take medications? If so, please medications he/she takes
Please provide (3) Emergency/ Pick-Up Contacts: 
Name and Phone Number 
 *
Does your child have any physical disabilities that would hinder them from participating in any camp activities?
 *
Select Summer Camp Weeks Attending
NOTE:  **Sign up for at least 3 weeks (full day) ...SAVE $150 or more*** PROMO ends April 30th. ONLY 40 SPOTS AVAILABLE!
 *
Required
SELECT PROGRAM RATE (select one)
NOTE: $150 will be taken off the 3rd week, then $50 off each week afterwards-PROMO ends April 30th**Full Day ONLY
 *
Required
By checking the box below, I agree to adhere to all Policies and Procedures. 

Payments are collected weekly (sent on Mondays and due by 9:00pm every Friday). Invoices are sent a week in advance to secure your child's spot for the following week.  I understand a $15 late fee will be applied if payment is not received by 9:00pm Friday. This late fee provides a payment extension ONLY until 5:00pm Sunday. I understand that if payment is not received by Sunday at 5:00pm, my child's name WILL NOT be on the attendance for the week and WILL NOT be able to attend camp that week.

I also understand that a $1 per minute Late-Pickup fee will be applied if my child is picked up after my designated pick-up time. Excessive late pick-ups will lead to program termination after 3 or more occurrences. All Late fees are added to your weekly tuition and must be paid in full before students are permitted to return to the program. 

I acknowledge that my student will be expected to maintain the program behavior standards at all times. Chronic/disruptive behaviors, behaviors which require constant attention, or behaviors which inflict harm/abuse to others are prohibited. Consistent disciplinary issues will result in suspension or termination from the program. I have discussed the expectations of conduct and behavior with my child(ren). 

I agree to adhere to all policies, agreements, waivers, and procedures as set forth by NextPrep Kids. 

I also agree to read and adhere to the terms outlined in the NextPrep Kids Summer flyer which was (or will be) provided to me.* *
 *
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