St. Justin Super Chargers Summer Camp 2019

Please fill out the following form. Once completed, a PDF will be emailed to you. Please PRINT, READ carefully all the terms and policies, SIGN the highlighted areas and TURN IN to the school office. REGISTRATION IS NOT COMPLETED UNTIL A SIGNED FORM IS RECEIVED.

** St. Justin Families- Summer Fees will be taken from SMART Tuition account in June and July. First week fee and registration will be taken when application form is turned in. Once weeks are billed there will be NO REFUNDS. All Drop-In days will require payment the day of service and an emergency form must be completed for us to take the student.

**Non-St. Justin Families- Payment by check must be attached to the PDF form and paid a week in advance.

Student Information
Student's First Name *
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Student's Last Name *
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Home Address *
Street, City and Zip
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Home Phone Number *
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Grade Level in Fall 2019 *
Current Age *
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Date of Birth
School Attending in Fall 2019 *
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Child Lives with... *
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