Summer Camp Admissions

We are excited that you are considering enrolling your child in Spanish Academy Summer Camp(s). You can read more about our summer camps here.

Child's Name (Name Child Goes By):*
(i.e. Please do not put "William (Billy) LastName", but rather, just "Billy LastName").
First Last
Child's gender*
- Boy
- Girl
Immersion Program*
Is your child currently enrolled in a Spanish Immersion Program?
- Yes
- No
Child's Birth Date*
All children must be be 2 years old by June 1, 2023.
MM slash DD slash YYYY

Authorized Carpool Pickup
Please list the people that you would like to authorize to pick up your child. We will not release your child, under any circumstance, to anyone other than his/her parents without written permission.
First Carpool Contact
First Last
First Carpool Contact Phone
Second Carpool Contact
First Last
Second Carpool Contact Phone
Emergency Contact
Please list local persons other than regular carpool drivers that we may call in case of an emergency if you cannot be reached and that has permission to pick up your child.
First Emergency Contact Name*
We will contact this person after attempting to contact Parent 1 and Parent 2.
First Last
First Emergency Contact Phone*
Second Emergency Contact Name
First Last
Second Emergency Contact Phone

Medical Information
All children enrolled at The Spanish Academy are required to have health insurance.
Child's Physician*
First Last
Physician's Phone Number*
Insurance Company*
Insurance Group Number*
Insurance Company Phone Number*
Health Problems, Allergies, or other important information
Please list any allergies, health concerns, or other important information we should know about your child. Please make sure your child's teachers and the school Director understand the severity of any allergies.
Symptoms displayed when having an allergic reaction:

Summer Camp 2023
Total
$0.00
Coupon
If you are a Spanish Academy employee, please enter employee discount code here:
Credit Card*
Card Details
Cardholder Name
Phone
This field is for validation purposes and should be left unchanged.

Summer Camp Admissions 2023