Child Information

Child's First and Last Name

Age *

Child's Birthdate *

Gender

Girl

Boy

Potty Trained? *

Yes

If not, there is a fee of $25 per week. We supply everything.

Primary Phone Number *

Home Address

Apt, suite, etc.

Country

City

State

Zip code

Email *

Other members in household

Where does your child attend school?

Has your child attended our camps before?

Yes

If yes, you can just check off the camps you want to attend and skip down to medical waiver, If nothing (doctor, insurance, caregivers, etc) has changed since last year. You can also skip down if you are a BBP student.

Please list any buddies you want your child to be grouped with

Blossoming Buds Preschool Summer Camps *

Camp #1: Art Camp: July 8-12

Camp #2: Zoo Camp July 15-19

Camp #3: Make It!- July 22-26 FULL, add to waitlist

Camp #4: Film Favorites- July 29 - August 2

Camp #5: Ocean – August 5-9

Camp #6: Holidays, Summer-style- August 12-16

DAY CAMP (don't forget to go back to website to sign up!)

MOVIE NIGHT (don't forget to go back to website to sign up!)

Please check the boxes of the camps you wish to attend

Important information we should know about your child: personality traits, likes/dislikes, habits, etc.

Parent/Guardian information

Parent/Guardian Name #1

Address Same as Student

Same

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Employer

Parent/Guardian Name #2

Address Same as Student

Same

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Employer

Other people allowed to pick-up

Name

Relation

Number

Name

Relation

Number

Name

Relation

Number

Medical Information

Pediatrician's Name *

Phone *

Health Insurance Provider *

Please list all allergies and health issues

Please list all medications

Medical Waiver

I hereby give permission for my child to receive emergency treatment by a qualified staff member at Blossoming Buds Preschool. I also give permission for my child to be taken to the hospital by an aid car, ambulance, or staff car, if necessary.
In the event of an emergency and I cannot be contacted, I further consent to any medical, surgical, and/or hospital care, when deemed immediately necessary or advisable by a licensed physician/hospital in order to safeguard my child’s health.
I understand that I am 100% financially responsible for any emergency treatment that my child receives, including paramedics/ambulance services.
By signing below you agree to the above medical waiver.

Parent Signature *

Captcha *

reCAPTCHA is required.

After you click submit, you will be on our payment page. All camp tuition is due now.

Summer Camp Registration

Summer Camp Registration Form

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ONLINE REGISTRATION