Summer Camp Registration To enroll your child in our summer camp programs, please complete the form below. Summer Camp Registration 2022 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 2022* 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 9/1/21) - $305 per week Pioneer (current pre-kindergarten, age 4 by 9/1/21) - $265 per week Explorer (current kindergarten-1st grade) - $270 per week Junior Camp Counselor (7th-8th grade) - $210 per week Adventurer (current 2nd grade-6th grade, age 7 by 9/1/21) - $270 per week Choose the Weeks Your Child Will Attend* Week 1 - June 13th Week 2 - June 20th Week 3 - June 27th Week 4 - July 5th Week 5 - July 11th Week 6 - July 18th Week 7 - July 25th Week 8 - August 1st Week 9 - August 8th Week 10 - August 15th Week 11 - August 22nd Week 12 - August 29th 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 Extra Activities Options (Pioneers/Little Pioneers)All activities for Pioneers or Little Pioneers take place over 8 weeks of camp. Soccer French Violin Extra Activities Options (Explorer/Adventurer/Junior Counselor)Please be sure your camper is attending the week of your selected activity. Soccer (8 Weeks) Karate (Week 3 - June 27th) Chess (Week 4 - July 5th) Archery (Week 5 - July 11th) Ice Skating (Week 8 - August 1st) French (8 weeks) Violin (8 weeks) Piano (8 weeks) Total $0.00 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, 2022. - Remaining half (minus the registration deposit) is due by June 8, 2022. - If your total financial commitment is less than $750, the entire payment is due by June 1, 2022. - Weekly tuition is accepted. Signature*EmailThis field is for validation purposes and should be left unchanged.