Application Received On:
Confirmation -
Send:
 Sent:

_______________________________________________________________________

ENROLLMENT APPLICATION
VALLEY VILLAGE CAMPUS
_______________________________________________________________________

STEP 1: PARENT INFORMATION
To begin, type in all necessary family information. A working Email
address is required as most camp communications are sent this way.
(This is NOT the K CAMP application)
_______________________________________________________________________

Are you a new, friend or returning family?
I am attending:
Days I will be attending:
Enroll me with friends:

MOM
First Name
Last Name
Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
Email
_______________________________________________________________________

DAD or SECOND GUARDIAN
First Name
Last Name
Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
Email
_______________________________________________________________________
Emergency Contact(s)
Phone Number
Family Doctor
Phone Number
Authorized person(s) to pick up my child(ren)
_______________________________________________________________________

STEP 2: HOW DID YOU HEAR ABOUT US?
In an effort to better target our marketing campaigns, please let
us know where you first heard about our program.
______________________________________________________________________
LA Parent
Friend
Flyer
Car Flyer
Banner
Internet
Postcard
At School
Other

STEP 3: YOUR FIRST CHILD'S INFORMATION
Complete all fields below for the first child you are enrolling
______________________________________________________________________
First Name
Last Name
Sex
Age in June
School
Current Grade

If you can, enroll me with my friends
I am attending camp alone
______________________________________________________________________

STEP 4: YOUR SECOND CHILD'S INFORMATION
Complete all fields below for the second child you are enrolling
______________________________________________________________________
First Name
Last Name
Sex
Age in June
School
Current Grade

If you can, enroll me with my friends
I am attending camp alone
______________________________________________________________________

STEP 5: YOUR THRID CHILD'S INFORMATION
Complete all fields below for the third child you are enrolling
______________________________________________________________________
First Name
Last Name
Sex
Age in June
School
Current Grade

If you can, enroll me with my friends
I am attending camp alone
______________________________________________________________________





STEP 6: WORKSHOP CHOICES FOR YOUR FIRST CHILD
You are now ready to select your first child's workshops. Please rememeber to
check daily workshop schedules BEFORE making your choices as some workshops
may already be closed. You and your child should select two choices of workshops
within each of the four time periods as your first choice may close between
the time you complete your application and the time we receive it.
If so, we will automatically enter your child into their second choice.

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30
______________________________________________________________________

STEP 7: WORKSHOP CHOICES FOR YOUR SECOND CHILD
You are now ready to select your second child's workshops. Please rememeber to
check daily workshop schedules BEFORE making your choices as some workshops
may already be closed. You and your child should select two choices of workshops
within each of the four time periods as your first choice may close between
the time you complete your application and the time we receive it.
If so, we will automatically enter your child into their second choice.

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30
______________________________________________________________________
STEP 8: WORKSHOP CHOICES FOR YOUR THIRD CHILD
You are now ready to select your third child's workshops. Please rememeber to
check daily workshop schedules BEFORE making your choices as some workshops
may already be closed. You and your child should select two choices of workshops
within each of the four time periods as your first choice may close between
the time you complete your application and the time we receive it.
If so, we will automatically enter your child into their second choice.
Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30


STEP 9: TUITION CALCULATION
Please select all the sessions you are enrolling in. Decide if you will
need extended care, which is billed at $7 per hour if you sign up in
advance, or if you want your children to have a camp T-Shirt.