Clear Form
☐ 2020-2021
☐ Summer 2021
☐ 2021-2022

Child's Information

☐ M
☐ F

Session

Please choose the sessions and program in which you would like to enroll your child.

8:30-11:30
11:30-3:00
☐ 1st-3rd Grade
Please select any extended day care you will need. *There may be additional fees for extended day hours.
Is your child fully potty trained?

Parent / Guardian 1

Parent / Guardian 2

Background information

Does your child have any special needs (educational, medical, psychological, or behavioral)? Has your child received any testing or evaluations that would relate to their academic or social performance? PVMS must have copies of tests or evaluations that your child has taken.
Does your child have any allergies or medical conditions? If yes, please explain:

Fees

This is a one time fee for the PVMS Summer Program. This fee must be paid to finalize enrollment.

New Families are required to pay a $50.00 application fee.

Activity Fee:**
This is a one time fee for the PVMS Summer Program. This fee must be paid to finalize enrollment.
Full Time $50.00
Part Time $30.00

Non-Discrimination Policy

Spots are limited. Admission preference is given to children currently enrolled at PVMS, and with siblings enrolled at PVMS. All children are admitted on a probationary basis. PVMS accepts students of any race, color, nationality, ethnic origin, or religious preference.