1Child Information2Family Information3Sign Application Child's Full Name* First Middle Last Child's Preferred NameChild's Birthdate* Month Day Year Child's Gender* Male Female Non-Binary Is this child a current WPELC student?* Yes No Is this child registered for the upcoming school year?* Yes No Summer Camp Eligibility This year’s summer camp is being offered to WPELC students registered for the upcoming 2024-2025 school year, and to WPELC students graduating in May 2024. If this child does not fit into either of these two categories, they may not be eligible to apply. Please contact Admissions at admissions@wpelc.org with any questions.Are you also submitting an application for another sibling?* Yes No Remember to submit a separate application for each child you wish to enroll.Full Name(s) of Child's Sibling(s):*Does your child have any allergies or special needs?* Yes No Please Explain*Is your child potty trained?* Yes No Summer Camp Week SelectionSummer Camp will be offered Monday-Thursday from 9am-1pm. (Exception: Week of June 17th – camp will be held Mon/Tues and Thurs/Fri). In the event of overwhelming demand (as determined based on applications received by the due date), we reserve the right to limit the number of sessions allocated to each child. See below for summer camp session choices. Cost: Cost: $292/session. Students enrolled for the current school year will receive invoices via Procare. Students newly enrolled for the upcoming school year will be invoiced via email via QuickBooks.My child will be 3 years old by June 1st.*Summer Camp is offered for children 3-5 years old (3 years old by June 1). Students must meet this age requirement to be considered for Summer Camp. Yes No How many weeks are you interested in having your child attend?* 1 week 2 weeks 3 weeks 4 weeks Summer Camp Week Choices — RequiredPlease drag to rank, in order of preference, the Summer Camp session(s) you would like your child to attend.June 17-18, 20-21: Space and Air ExplorationJune 24-27: Bubbles, Bubbles, BubblesJuly 8-11: Back to NatureJuly 15-18: Water WorksIs there any information we should take into consideration with your Summer Camp week selection(s)?i.e: If we cannot offer you all selected sessions, do you have preferences/priorities? Parent / GuardianName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Primary Phone*Secondary PhoneDoes this child have a second parent/guardian?* Yes No Second Parent / GuardianName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Main Phone*Second Phone Is there anything else that you'd like us to consider along with your application?Admissions Process Summer Camp spots will be filled with priority registration given to: 1. Students registered for the 2024-2025 school year (both returning and new-to-WPELC) 2. 2023-2024 students who are Kinder-bound and/or outgoing 3. Alumni 4. New students In the event of overwhelming demand, we reserve the right to limit the number of sessions allocated to each child.Nondiscrimination Policy WPELC admits students of any race, color, national and ethnic origin and religion to all the rights, privileges, programs and activities generally accorded or made available to students at the school, and it does not discriminate on the basis of race, color, national and ethnic origin or religion in administration of its educational policies, admission policies, and scholarship program, and athletic and other school administered programs. Please note that, although we are located in a church building, we are nonsectarian.SignatureOnline Application Acknowledgement*Once you press the Submit button, your information will be sent to Washington Park Early Learning Center. You will receive a confirmation email with your submitted information. If you do not receive this confirmation, your form was not submitted properly. Please email admissions@wpelc.org if you do not receive the confirmation or the submitted information is incorrect. I understand First Parent/Guardian Signature*Second Parent/Guardian Signature*
