Summer Camp Registration To enroll your child in our summer camp programs, please complete the form below. "*" indicates required fields Child's Name* First Last Child's Date of Birth* MM slash DD slash YYYY Current Age*Please enter a number from 0 to 18.Gender* Male Female Grade Completed by June 2023* Child's Address* Street Address Address Line 2 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 Parent 1 Name* First Last Parent 1 Address* Same as child's address Street Address Address Line 2 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 Parent 1 Email* Parent 1 Phone*Parent 2 Name First Last Parent 2 Address Same as child's address Street Address Address Line 2 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 Parent 2 Email Parent 2 PhoneCamp SelectionAge Group*Includes: meals, beverages, and snacks. No additional cost for before/after camp. Note - there is a $35 per week discount applied if you sign up for 5 or more weeks. Little Pioneer (current pre-school, age 3 by 9/1/22) - $305 per week Pioneer (current pre-kindergarten, age 4 by 9/1/22) - $265 per week Explorer (current kindergarten-1st grade) - $270 per week Adventurer (current 2nd grade-6th grade, age 7 by 9/1/22) - $270 per week Junior Camp Counselor (7th-8th grade) - $210 per week Choose the Weeks Your Child Will Attend* Week 1 - June 19th Week 2 - June 26th Week 3 - July 3rd Week 4 - July 10th Week 5 - July 17th Week 6 - July 24th Week 7 - July 31st Week 8 - August 7th Week 9 - August 14th Week 10 - August 21st Week 11 - August 28th HiddenTotal Number of WeeksHiddenCamp Subtotal (< 5 weeks selected)HiddenCamp Subtotal ( includes discount for >= 5 weeks)Total for Selected Weeks including discount if applicable Price: $0.00 Little Pioneers & Pioneers - Extra Activities OptionsFor Little Pioneers and Pioneers, we offer the extra activities below. Please be sure your camper is attending the week of your selected activity. Soccer (Thursdays, 8 week session, ages 8 and under) Karate (Tuesdays, June 20-July 25) Karate (Tuesdays, August 8-22) Explorers, Adventurers & Junior Counselors - Extra Activities OptionsFor Explorers, Adventurers, and Junior Counselors, we offer the extra activities below. Please be sure your camper is attending the week of your selected activity. Soccer (Thursdays, 8 week session, ages 8 and under) Karate (Tuesdays, June 20-July 25) Karate (Tuesdays, August 8-22) Total Please note: Activity fees are billed in addition to tuition. Complete the registration form and return with a $200 deposit (applied to last week of camp's tuition) Submit paper forms or checks to the Administrative Office, 7901 Ridge Avenue, Philadelphia, PA 19128 Make checks/money orders payable to Les Petits Cherubs. Submit payments to: Les Petit Cherubs Administrative Office Online via PayPal (link is provided after submission of form - Enrollment is limited. - All activities are tentative and subject to change. - There are no refunds given for illness or injury. - Activity fees will be refunded only if an entire weekly activity is cancelled by Les Petits Cherubs. - Half of the summer camp financial commitment is due by June 1, 2023. - Remaining half (minus the registration deposit) is due by June 8, 2023. - If your total financial commitment is less than $750, the entire payment is due by June 1, 2023. - Weekly tuition is accepted. Signature* Reset signature Signature locked. Reset to sign again EmailThis field is for validation purposes and should be left unchanged.