St. Eugene Summer School
300 Farmers Lane
Santa Rosa, CA 95405
Phone: 545-7252 – Fax: 545-2594
Registration Form
Name of Student: ______Present School: ______Grade in Sept.: _____
Mother’s Name: ______Home Phone: ______Work Phone: ______
Address: ______City: ______ZC: ______Cell Phone: ______
Father’s Name: ______Home Phone: ______Work Phone: ______
Address: ______City: ______ZC: ______Cell Phone: ______
If single parent household, student lives with: ______Mother______Father
Local Emergency Contact: Name: ______Phone Number: ______
Program
Classes will be held from 9:00 a.m. to 2:30 p.m. June 13th to July 15th with the exception of Monday, July 4th. Our full day morning session (grades 1-6) includes math, reading and writing taught around exciting and engaging themes. Afternoon classes for grades 1 and 2 will include arts and crafts and movement and games. Computers, arts and crafts, reader’s theater, and sports offered to the 3rd, 4th, 5th, and 6th grades. Grades three and four will be combined and grades five and six are combined. Grades one and two will not be combined. The cost for the five-week full day summer program is $720.
Junior High Students
For junior high students (7th and 8th graders), we are offering a full-day program from 9:00am to 2:30pm. The junior high students will be involved in academics such as reading, English, writing and math. They will also experience reader’s theater, art, sports, and a Christian service component. The cost is $720.00. The junior high program must have a minimum of 10 students.
Day Care
Day Care will be available prior to and following the summer program from 7:30 a.m. to 9:00 a.m. ($110 for the five-week session) and 2:30 p.m. to 5:30 p.m. ($235 for the five weeks). Day Care will cost $3.80 an hour and/or $1.90 per half hour if needed on a “drop-in” basis.
Remedial Tutoring Available
Remedial tutoring, will be offered in math and reading as a pullout program during the regular summer program day. Individual tutoring (1/2 hour sessions) will be offered twice a week for an additional fee of $150 and three times a week for $220.
Deposit
In order to hold a seat for your child, an initial non-refundable deposit of $100 must be submitted by May 1st. The remaining balance is due by June 1st. Confirmation will be mailed upon receipt of this registration form and your deposit. Checks payable to St. Eugene Summer Program should accompany this registration form.
I am enrolling my child in the following session and Day Care options:
____ Full Day Session - $720___ Day Care – 7:30-9:00 a.m. - $110Tutoring: ___ 2 x individual $150 (10 sessions)
____ Junior High Program - $720___ Day Care – 2:30-5:30 p.m. - $235 ___ 3 x individual $220 (15 sessions)
___ Drop-in charged at $3.80/hourSubject Area:______
$1.90/half hour
______
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For Office Use Only:
Date Received: ______Amount Received: ______Cash: ______Check #: ______