Mi Mundo Summer Camp Registration
Admission is on first come, first served basis. Please complete this form no later than June 22.

The camp is 5 weeks long.

When: July 2nd- August 3rd, 2018
Contact: MiMundoNYC@gmail.com

Email address *
Child's Full Name *
Your answer
Parent 1 Full Name *allowed to pick up *
Your answer
Parent 2 Full Name *allowed to pick up
Your answer
Email *
Your answer
Choose your weeks of attendance. Remember Summer hours are M-Th 9am-5pm and Fridays are 9am-4pm. Minimum attendance and payment is 3 days a week, priority given to full-time kids. *
Required
Which days do you request? *Non-transferable *
Required
Emergency Contact Full Name (other than guardians) *allowed to pick up *
Your answer
Emergency Contact Phone Number (other than guardians) *
Your answer
I understand that I will have to pay an art and supply fee of $20, plus any other admissions fees in case of field trip. (Mostly for the kids age 3+), and once I select these weeks I am committed to paying for them. *
Required
I understand that my child has to submit a current version of the NYC Health Form found here. (It should at least be from this past academic year) http://schools.nyc.gov/NR/rdonlyres/6243A6FA-28A1-4E21-8378-06095CA6EFFB/0/CH205HealthExamJune2016.pdf PLEASE GIVE TO SUSI. *
Required
Comments
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service