Nursery School …Summer Session 2017

Trinity Lutheran Nursery School
Summer Session at Trinity
May 30 to August 3
(no camp July 3,4,and 5)
Join us for an extended Summer Camp Session
Tuesday, Wednesday & Thursday mornings 9 to 11:30 $70.00 a week
2 mornings 9 to 11:30 $ 50.00 a week

Lunch Bunchers until 1:30 ( $10.00 a day) Late Show 1:30 to 3:00 ( $10.00 a day)

Registration
Name__________________________________ Age________
Address_________________________________Cell Phone__________
________________ ___________e mail address_____________________________
Phone__________________
Class presently attending___________________
Allergies_________________________________
Food Sensitivities__________________________
Pediatrician__________________Phone________
In case of emergency:
Name_________________Phone_____________
Name_________________ Phone_____________

I give permission for my child____________to receive EMT ____________________(signature)
Please circle the weeks you are interested in participating and on the line next to the week fill in the number of days…2 or.3
May30……..”Star War’s Space Frontier “______
June 6………. “Super Heroes”______
June.13…….. “Disney Magic“________
June 20……. “Win It In A Minute””_________
June 27…….. “Made in the USA”________
July 11………“Things That Go….”_____
July 18……….Creepy Crawlers” _______
July 25………..”Mad Science”______
August 1……. “Rumble In The Jungle”.______
Please complete and return with the fee for the first week of participation before May 1st.

Weeks participating__________________ Amount due_____________-

Please return the form to school before May 1st with a $70.00 deposit which will be credited to the first week of camp.

PLEASE COMPLETE THE REVERSE SIDE PICK UP INFO
Trinity Lutheran Nursery School & Mothers’ Morning Out

Child’s Name_________________________________

Class_______________________________________

Emergency Contact information:
In the order of notification
Name Relation Phone number
1.___________ __________________ ______________
2.___________ ___________________ ______________
3.___________ ____________________ _______________
People Permitted to pick up your child from school:
Name Relation Phone
1._____________ __________________ _________________
2._____________ ___________________ ________________
3._____________ ____________________ ________________
4.____________ _____________________ _________________

Allergies:__________________________________________________
Food Sensitivities_________________________________________________________
Does your child have asthma? yes or no
Does your child have an inhaler ? Yes or no Does your child have an epi pen? yes or no

e mail address___________________________________________________

I give my permission for my child _____________________________, to have her photo taken at school for our facebook page and web page.

Please attach photo