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☐ 2021-22
☐ 2022 Summer
☐ Summer (8:00am-4:00pm)


☐ M
☐ F
Does your child have any known allergies?
Which diet best fits your child?

Parent / Guardian 1

Parent / Guardian 2

Background information

Please list every school that your child has attended
What are your goals for your child this summer? How do you see us facilitating these goals?
Does your child have any hobbies, sports, or special interests, capabilities or talents?
How do you see your child in their social and emotional development?
Please describe your child's educational experience thus far. What has been successful? What has been challenging?
What kinds of challenges has your child faced as a result of recent pandemic-related conditions? How can I help?
Does your child have any special needs (educational, medical, or psychological)? Has your child received any testing or evaluations that would relate to their academic or social performance? Please have copies sent of tests or evaluations that your child has taken.
Are there any areas in which I may be able to give special help and encouragement to your child?

Non-Discrimination Policy

We value diversity among our students. We do not discriminate in our enrollment policies on the basis of race, color, gender, religion, sexual orientation, national or ethnic origin.