Summer Enrollment Form - Mequon Jewish Preschool

B"H

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Summer Camp 2014

June 23 ~ August 15
No Camp July 4

Please fill out the form below to enroll in Summer Camp.
Enrollment forms received by April 7 will receive special pricing.
Summer Camp enrollment deadline is May 30, 2014.

* Indicates required field

Child's Name *

First

Last

Date of Birth *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Father's Name *

First

Last

Cell Phone Number *

Work Phone Number *

Email *

Mother's Name *

First

Last

Cell Phone Number *

Work Phone Number *

Email *

9:00 am - 12:30 pm *

Monday Tuesday Wednesday Thursday Friday

12:30 pm - 3:30 pm *

Monday Tuesday Wednesday Thursday Friday

7:30 am - 9:00 am *

Monday Tuesday Wednesday Thursday Friday

8:00 am - 9:00 am *

Monday Tuesday Wednesday Thursday Friday

3:30 pm - 4:30 pm *

Monday Tuesday Wednesday Thursday Friday

3:30 pm - 5:00 pm *

Monday Tuesday Wednesday Thursday Friday

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