ࡱ>    !"#$%&'()*+Root EntryZ O2',CONTENTS RCompObjVSPELLINGXedical help in case of emergency on behalf of my child, ________________________________________________. I understand that I will be notified immediately should an emergency arrive, but in my absence, Greenhouse Montessori will take action suitable to the needs that arise. I understand that I am responsible for any charges and medical coverage that apply to my child, including but not limited to, ambulance and hospitalization. **I am including a non-refundable registration fee of $200 for half day, $250 for full day, along with this form to ensure space for my child. $50 goes toward registration. ** I understand that summer payment is due in full by May 14th, 2007. If not received, I have forfeited my space and registration fee. **Camp hours are from 8:30-11:30, or 8:30-2:30 Any child left on premise after 11:35 for half day, or 2:35 for full day will be charged $10 per 10 minutes. In the event that late pick-ups exceed 3 times within a session, the child will be dismissed from the program without refund. ** I will apply sunscreen to child prior to coming to camp EACH DAY. **I will drop off my child at their camp room each morning and sign them in. I will pick up my child from their camp room AFTER I HAVE SIGNED THEM OUT. Greenhouse Montessori will only release children to other parties with written consent from the parent in ADVANCE. It is expected that children will be picked up and dropped off by the same person. Any changes (grandparents, carpool, other parents) will only be allowed if set up in ADVANCE. **I will submit this form as well as the Emergency Information and Immuization Record Card upon enrollment. I understand that my child will not be admitted to the program without these forms submitted by May 14, 2010. **Greenhouse Montessori rCHNKWKS RTEXTTEXTFDPPFDPP"FDPCFDPC$FDPCFDPC&STSHSTSH(@STSHSTSH@(\SYIDSYID(SGP SGP (INK INK (BTEPPLC (BTECPLC ( FONTFONT(jSTRSPLC Z):PRNTWNPR)&FRAMFRAM8PTITLTITLPJDOP DOP Qake action suitable to the needs tha Greenhouse Montessori CAMP information sheet Child s Name:______________________________________ Mother s Name:_________________ Father s Name:______________________ Mother s contact #:_____________Father contact#:______________________ Address:________________________________________________________________ E-Mail address:______________________________________________________ Child s Date of birth:____________________Age:______________ Allergies or special needs?_________________________________________________________________________________________________________________________________________________________________________________________ Pricing: For 6 week session, Monday- Thursday June 7th-July 15, 2010 Pricing(ages 3-9): Students enrolled in school session pricing: Non student pricing: 6 week program=$500half day(8:30-11:30) $600 weekly drop in =$110 half day (8:30-11:30) weeks____________ $120_________________ 6 week program=$850 full day (8:30-2:30) $1100 weekly drop in=$170 weeks_________________________$210___________ Pricing ages 1-2 (6 week only option) Half day $625 (8:30-11:30) $725 Full day $950 (8:30-11:30) $1200 Please note that the above prices do NOT include a $50 registration fee. Extended care available from 8-4, billed at $5 per hour with 24 HOUR advance notice. Any enrichment programs are additional, but full day campers can take 20% off the added price. We look forward to providing your child with fond summer memories. Thank you for your patronage. Sincerely, Jennifer Papp Greenhouse Montessori **I,________________________(parent s name) give Greenhouse Montessori authorization to call for meserves the right to dismiss any child from the program for inappropriate behavior including, but not limited to, violence, profanity, unsportsmanship, or bullying, without program refund. I comply with the above conditions. If at any time my child or I do not follow the above conditions, the program may be ended at the discretion of Greenhouse Montessori. ________________________________________________________________ Parent s name printed Parent s signature Date ill take action suitable to th3\Nntf b $  \ J L <hz R!!!!!!!!!!(2"'( ) @S  !"1""1f2 \ lBlBll($ 08."Rh. "!$  08, "!$  08, $  08*$  08&$  08n$h (08@HPX`hpx0<@N!!x $h (08@HPX`hpxn$h (08@HPX`hpxt $h (08@HPX`hpx,pTSH Normal (Web)HpTSH,: "   * "   *tt!"!$&VxONT 0FTimes New RomanRockfordArial " " "XXNNNX%$HP Officejet Pro L7700 Series$CdXXDINU"$ zTSMTJHP Officejet Pro L7700 SeriesInputBinFORMSOURCERESDLLUniresDLLHPPreAnalysisFalseMSPreAnalysisFalseHPReportSymmetricMarginsFalseHPMinimizeMarginsFalseHPAlignMarginsForMDTrueDuplexNONEHPPrintPreviewFalseHPOverSprayOptionAutomaticHPOverSpray100HPBorderLessPhotoFalseHPOutputOrderReverseTrueJobUITruePaperSizeLETTEROrientationPORTRAITHPPaperSizeDuplexConstraintsINDEX_CARD_3X5HPDocPropResourceDatahpzhl4x6.cabHPNUseDiffFirstPageChoiceTrueHPMediaTypeDuplexConstraintsHP_MATTE_GREETING_CARDSHPDryTimeOptionAutomaticHPDryTime0HPInkVolumeOptionAutomaticHPInkVolumeNormalHPPrintInGrayScaleFalsePrintQualityNormalPrintQualityGroupPQGroup_2HPJobAccountingHPJOBACCT_JOBACNT_TIMESTAMPHPColorModeCOLOR_MODEHPPDLTypePDL_PCL3HPPJLEncodingUTF8HPXMLFileUsedhpwl7703.xmlHPTilingSelectionTrueHPMediaTypeTreeviewPopupTrueColorModeColor24TextAsBlackFalseMediaTypePLAINResolution600dpiPQDPIInstalledHPMirrorPrintTrueHPAutoDuplexScalingTrueHPManualFeedOrientationFACEUPHPSpeedMechFastDraftHPOutputBinOrientationFACEUPHPMapManualFeedToTray1FalseHPSendPJLUsageCmdLNNAME_CARRPSAlignmentFileHPZ3A4x6PSServicesOptionServiceFileEndHPCleaningFilesDataHP_Clean_TestPageHPConsumerCustomPaperHPCustomHPColorSelectionForHPAEnabledHPSmartDuplexSinglePageJobTrueHPBornOnDateHPBODHPInputColorSpaceCOLORSMARTHPDriverDataDriverDataHPCustomSizeCommandTRUEHPSendPreloadCommandTRUEESPRITSupportedTrueHPUseAutoDuplexUnitTrueHPHideManualFeedTrueHPRESDLLNameHPFRS4x6HPRedEyeReductionOffHPDigitalImagingHPHomePrintingHPSmartFocusOnHPContrastOnHPDigitalFlashOnHPSharpnessLowHPSmoothingOnHPJpegPngPassthroughTrueHPReverseBandOrderForEvenPagesReverseBandOrderHalftoneHT_PATSIZE_DEFAULTHPHTDLLNameHPFIG4x6HPMHDLLNameHPFIE4x6HPHPAFilterTrueHPAdvancedColorSettingTrueHPICCPrinterFamily5700_6500HPCRDCommandTrueHPSendUnitMeasureCommandTRUEHPPaperSizeTreeviewPopupMetricHPSimplifiedUITrueHPPosterPrintingOptionSUIFalseHPPhotoFixOFFHPScaleToPaperFalseHPConvertAPIVersionOverride3IUPHdLetter o [none] [none]Arial4Pd?JENNIFER<Automatic>44Custom Print SettingsdThunking Spooler APIS from 32 tNoneFactory Defaultssplwow64.exeC:\Windows\splwow64.exeIPACDRWDSGATCAPI;F4E8Q;Ki݅&E%9xPPBHAERP/winspoolHP Officejet Pro L7700 SeriesUSB002F"\""V"4"` "`""A."@"\""V"4"` "`"."summer camp enrollment form 2010.wps"p"p anship, or bullying, without program refund. I comply with the above conditions. If at any time my child or I d Z O2Quill96 Story Group Class9qy`y`y``y``O y`Z `y``|y`