/ SUMMER CAMP Application
7071 Forestville Rd. Knightdale, NC 27545 | 919-266-2373

Child’s Name
Please write child’s name in box / Date of Birth / Gender / Age/Grade* / Circle if attending Entire session / Circle if attending weekly camps
1. / M F / 3 4 K-1st / Session 1
Session 2 / Week 1 Week 2 Week 3 Week 4
Week 1 Week 2
2. / M F / 3 4 K-1st / Session 1
Session 2 / Week 1 Week 2 Week 3 Week 4
Week 1 Week 2
3. / M F / 3 4 K-1st / Session 1
Session 2 / Week 1 Week 2 Week 3 Week 4
Week 1 Week 2

Camp Offerings:Camps are from 9:00 am-1 pm;Monday-Thursday

Session / Dates / Theme
1 / June 6-26,2015
Week 1: June 6-9 / Capes & Crowns
Week 2: June 13-16 / It’s a Bug Life- Camp out!
Week 3: June 20-23 / Barnyard Buds
Week 4: June 27-30 / Adventures in Space
2 / July 18-30, 2015
July 11-15** / Vacation Bible School@ KUMC*
Week 1: July 18-21 / Summer Olympics
Week 2: July 25-28 / Water Fun

* Register for VBS @ for age 3 (potty-trained) and up.

Cost: Weekly camps total cost is $90.

If signing up for the entire 3 week session the total cost is $250 per session. Discount amount must be paid at time of registration. These fees are non-refundable.

Student Information:Please circle the Age/Grade and your camp selection for each child. If signing for the entire session please circle the session number.


Mother’s Name:
Mother’s Contact Information: /
Father’s Name:
Father’s Contact Information:

Home address: /
Home address:

Home Phone: /
Home Phone:

Cell Phone: /
Cell Phone:

Place of Employment: /
Place of Employment:

Work Phone:
/
Work Phone:

General Information:

  • Please make sure t hat the email at the top of this form is an email you check regularly. We try to be as paperless as possible and most of our communications come through email, Facebook, and our website..
  • Children need to bring their own snack and lunch daily.
  • All children attending camp must have a Medical form on file in the preschool office. Medical forms can be download from our website and last for 1 year.

Knightdale UMC Preschool does include photos of students, teachers, and school activities on its website. The names of children will not be used. I hereby give permission for Knightdale UMC Preschool to use photos of my child(ren) on the preschool website and other electronic forms of communication. Yes No

How did you hear about us? Who refered you?______

Discipline Policy:

Discipline comes from the word disciple, which means, “one who is a learner”. Therefore, disciple is a positive word, not a punitive action. Effective classroom management will start with encouraging acceptable behavior by giving positive verbal praise. For a child not cooperating in a group setting a verbal reminder will be used to set the standard of acceptable behavior, and then the child would be re-directed. “Time- Out” will be used for a child who continually/and or Initially demonstrates unacceptable behavior. This time away from the group is used to help the child calm down and remember the appropriate behavior for the classroom setting. Time–out lasts one minute for each year of the child’s age. If the behavior problems persist, the parents will be asked to have a conference with the teachers and director to work together to motivate the child to demonstrate positive behavior. ______(please initial)

Knightdale UMC Information:

Would you like to be added to our church mailing list to recieve information about upcoming church activities?

_____Yes_____No

Guardian’s Signature______Date______

For Preschool Useage
Registration Check #______Amount of Check $______Date Received______
Tuition Check #______Amount of Check $______Date Received______
Emailed availabilty/acceptance for class ______Date______