SUMMER PROGRAM APPLICATION ONLY *

First Name

Last Name

Primary or Toddler *

Is your child signing up for the Primary or Toddler Program?

Primary - Rector Street

Toddler - Liberty Street

Will your child be attending Hudson Hills in the Fall?

Yes

No

Please check off which weeks your child will be attending.

WEEK 1 - 6/30 -7/3 - No Camp 7/4

WEEK 2 - 7/7-7/11

WEEK 3 - 7/14-7/18

WEEK 4 - 7/21- 7/25

WEEK 5 - 7/28-8/1

WEEK 6 - 8/4-8/8

WEEK 7 - 8/11-8/15

WEEK 1 6/30-7/4

Liberty WEEK 4 Day Week

4 Half

4 Full

WEEK 2 7/7- 7/11

Nature Week

4 Half

4 Full

5 Half

5 Full

WEEK 3 7/14-7/18

Fun in the Sun

4 Half

4 Full

5 Half

5 Full

WEEK 4 7/21 - 7/25

Storybook Week

4 Half

4 Full

5 Half

5 Full

WEEK 5 7/28-8/1

Animals around the World

4 Half

4 Full

5 Half

5 Full

WEEK 6 8/4-8/8

LITTLE CHEFS WEEK

4 Half

4 Full

5 Half

5 Full

WEEK 7 8/11-8/15

Dinosaur Week

4 Half

4 Full

5 Half

5 Full

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Cell Phone

(###)

###

####

We certify that no information concerning this applicant has been withheld or misrepresented.*

First Name

Last Name

At Hudson Hills , we frequently take photographs of our children. Some of these photos will be used in promotional pamphlets , internal school newsletters , newspaper advertisement , annual reports , on the school website , and for the annual school yearbook among other places . On rare occasion , we will invite print local newspapers to Hudson Hills to cover events. If you agree to provide permission for your child's name and image to appear in the media or in any school publication , check here:

YES

NO