Summer Program Application printable pdf download

Summer Program Application

MONTESSORI T IDES S CHOOL

2013 S UMMER P ROGRAMS A PPLICATION

CHILD’S N AME___________________________________________________

AGE A ND B IRTHDATE______________________________________________

PARENT N AMES(S)________________________________________________

ADDRESS________________________________________________________

TELEPHONE ( H)___________ C ___________ W _________________________

EMAIL___________________________________________________________

EMERGENCY C ONTACT

NAME A ND P HONE__________________________________________________

LIST A NY F OOD

CONSIDERATIONS_______________________________________________________________________________

Please c heck s ession(s) d esired:

THE A RT A ND S CIENCE O F N ATURE

SESSION 1

JUNE 3 -‐7

_________

SESSION 2

JUNE 1 0-‐14 _ ________

SESSION 3

JUNE 1 7-‐21 _ ________

SESSION 4

JUNE 2 4-‐28 _ ________

COST P ER S ESSION $ 175

AFTERCARE C OST $ 20 P ER S ESSION _ ________

10% D iscount o n 2

c hild. P lease m akes c hecks p ayable t o Z azo M ontessori a nd m ail t o:

Montessori T ides S chool

1550 P enman R oad

Jacksonville B each, F L 3 2250

Summer Program Application