2021 St. John's Preschool Summer Program Registration Form
Please complete one registration form per child. Your child's space can only be confirmed once the 50% tuition deposit is received. Please pay the 50% deposit by check or bank initiated check.

By using your e-signature to complete this form, you agree to the terms outlined in the 2021 Summer Program Information Brochure.
Email address *
Child's Last Name: *
Child's First Name (include preferred name): *
Date of Birth: *
Tuition Details
Please enroll my child in: *
Parent 1 Name: *
Parent 1 Phone: *
Parent 2 Name: *
Parent 2 Phone: *
Parent 2 Email: *
Child's address:
Please tell us about your child's previous school/camp experiences: *
Please describe any special needs the staff should be aware of to support your child: *
How did you learn of St. John's Summer Program
Clear selection
E-Signature: *
A copy of your responses will be emailed to the address you provided.
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