Summer Care 2024 Enrollment

Please complete the form below by April 24th to enroll your child in the 6 to 6 Summer Care Program:

Summer Care 2024 Enrollment Agreement

Parent/Guardian Information
Parent/Guardian Name:*
Email*
Phone*
Address*
Street Address City State ZIP Code
Please list all children that will be attending summer care.
*
Click the (+) to add information for addition children.
Child's Full Name Birthdate Grade (2023-2024) Gender
*
Indicate the weeks of programming your child will attend. Please note that summer care will be CLOSED Thursday, July 4th and Friday, July 5th.
- June 3 to June 7
- June 10 to June 14
- June 17 to June 21
- June 24 to June 28
- July 1 to July 3
- July 8 to July 12
- July 15 to July 19
- July 22 to July 26
- July 29 to August 2
- August 5 to August 9
- August 12 to August 16
*
Mark the days your child(ren) will attend each week.
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
What time will your child(ren) typically be dropped off?*
What time will your child(ren) typically be picked up?*
Read the statements below. Sign to indicate you acknowledge the statements.
*
- I understand that a non-refundable deposit of $50 per child ($75 max per family) will be charged upon confirmation of enrollment. Paid deposits will be applied to your first bill in June.
- I agree to complete all required forms prior to my child attending.
- I have read and agree to follow the terms in the Trojan 6 to 6 Extended Care Program Handbook.
- I will provide lunch for my child, including a drink, each day. I understand that children will NOT have access to a refrigerator or microwave.
- My child(ren) will be picked up by 6:00 PM or I will be charged additional fees.
- I understand that I am required to sign my child(ren) in at drop-off and out at pick-up each day.
- I understand that my child(ren) will be required to follow PBIS expectations while attending summer care. The director and/or coordinator have the discretion to prohibit my child from attending due to behavior.
- Charges for the upcoming week of care will be entered into JMC each Friday before the upcoming week of care. You can give payment to childcare staff or pay online through JMC (a fee for online payment does apply).
- If payment is not received by 3:00 pm each Wednesday, child(ren) may not attend until payment is made or arrangements are made with the superintendent's office.
- I give permission for my child to go off premises for field trips within State Center (ex: splash pad, city parks, library, nursing home).
- I give permission for my child to swim at the Melbourne pool and use the adjacent playground.
Parent Electronic Signature*
By typing my name and dating below, I acknowledge the statements above.
Name Date

Child's Full Name	Birthdate	Grade (2023-2024)	Gender

Please complete the form below by April 24th to enroll your child in the 6 to 6 Summer Care Program:

Summer Care 2024 Enrollment Agreement

Parent/Guardian Information

Please list all children that will be attending summer care.

Read the statements below. Sign to indicate you acknowledge the statements.