The Rabbi Arthur Schneier Park East Summer Program runs from Monday, June 24th, 2024 through Friday, August 9th, 2024.

Child's Name:*

First Last

Birth Date*

Child's Gender*

School Presently Attending (if any):

School Attending as of September 2024:

Child's Grade as of September 2024*

Parent's Name*

Prefix First Last

Parent's Cell*

Parent's Email*

Additional Parent's Name*

Prefix First Last

Additional Parent's Cell*

Additional Parent's Email*

Home Address:*

Street Address Address Line 2 City State ZIP Code

Is your child entering Nursery 2s or Trans 3s and only attending 3 DAYS a week? Pick the days you wish for your child to attend:

Choose the weeks you wish your child to attend the program:*

Comments:

Full Payment Registration

For 2s and Trans 3 (3 Days)

For 2s and Trans 3 (5 Days)

For 3s (5 days, 9am-12pm)

For 3s (5 days, 9am-2pm)

For 4s

Total

$0.00

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