Summer Care 2026 Enrollment

Complete the following form to enroll in 2026 Summer 6 to 6 Care:

Please complete the form by Friday, April 24th.

Summer Care 2026 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 (2025-2026) Gender
*
Indicate the weeks of programming your child will attend. Please note that summer care will be CLOSED Friday, July 3rd.
- June 1 to June 5
- June 8 to June 12
- June 15 to June 19
- June 22 to June 26
- June 29 to July 2 (Closed July 3)
- July 6 to July 10
- July 13 to July 17
- July 20 to July 24
- July 27 to July 31
- August 3 to August 7
- August 10 to August 14
*
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 and must be paid within two weeks. 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.
- I will provide sunscreen for my child(ren), and will complete an additional sunscreen consent form on their first day in attendance.
- 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 has 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

You will receive confirmation of enrollment the week of April 27th via an email from program director Lori Shaffar which will include instructions on how to pay the deposit to secure your spot(s).

Child's Full Name	Birthdate	Grade (2025-2026)	Gender

Complete the following form to enroll in 2026 Summer 6 to 6 Care:

Please complete the form by Friday, April 24th.

Summer Care 2026 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.

You will receive confirmation of enrollment the week of April 27th via an email from program director Lori Shaffar which will include instructions on how to pay the deposit to secure your spot(s).