Summer Program Registration – Newton Waban – Nido (15 months-5 years) Step 1 of 3 33% Summer Program Registration - Newton Waban - Nido (15 months-5 years) Parent/Caregiver Name(s):*Address* Street Address City State / Province / Region ZIP / Postal Code E-mail* Primary Phone Number*Secondary Phone NumberEmergency contact:*NamePhone Number Child 11. Child’s Name*Birth Month and Year*AllergiesSpanish Experience*YesNoChild 1 Summer Camp: Price: $0.00 Please check the weeks your child will be attending: Week 1: July 5-8 Week 2: July 11-15 Week 3: July 18-22 Week 4: July 25-29 Week 5: Aug 1-5 Week 6: Aug 8-12 Week 7: Aug 15-19 Week 8: Aug 22-26 July Holiday Price: -$80.00 Extended days (3:00-5:00 PM)?*yesnoNumber of Extended Care weeks*$150 full week Price: $150.00 Quantity: add child?*yesnoChild 22. Child’s Name*Birth Month and Year*AllergiesSpanish Experience*YesNoChild 2 Summer Camp: Price: $0.00 Please check the weeks your child will be attending: Week 1: July 5-8 Week 2: July 11-15 Week 3: July 18-22 Week 4: July 25-29 Week 5: Aug 1-5 Week 6: Aug 8-12 Week 7: Aug 15-19 Week 8: Aug 22-26 July Holiday Price: -$80.00 Extended days (3:00-5:00 PM)?*yesnoNumber of Extended Care weeks*$150 full week Price: $150.00 Quantity: add child?*yesnoChild 33. Child’s Name*Birth Month and Year*AllergiesSpanish Experience*YesNoChild 3 Summer Camp: Price: $0.00 Please check the weeks your child will be attending: Week 1: July 5-8 Week 2: July 11-15 Week 3: July 18-22 Week 4: July 25-29 Week 5: Aug 1-5 Week 6: Aug 8-12 Week 7: Aug 15-19 Week 8: Aug 22-26 July Holiday Price: -$80.00 Extended days (3:00-5:00 PM)?*yesnoNumber of Extended Care weeks*$150 full week Price: $150.00 Quantity: Total $0.00 Payment Method:*CheckChecks should be made payable to and mailed or to the following location: SIMS Of Waban (1671 Beacon street, Waban, MA 02468) or drop off at 1671 Beacon street, Waban, MA 02468Photographic ReleaseOccasionally we photograph or videotape classes for promotional purposes. Do we have your permission to use photographs of your family in our promotional materials, provided that any identifying information, such as names, remain anonymous?*YesNoPolicies and DetailsPayment & Registration: Enrollment requires both a completed registration form and payment received by SIMS. Checks should be made payable and mailed or drop off according to the corresponding location: SIMS Of Newton (991 Boylston Street, Newton, MA 02461), SIMS Of Waban (1671 Beacon street, Waban, MA 02468), and SIMS Of Newton Corner (75 Vernon street, Newton, MA 02458). The space is not guaranteed until payment is received in full. Refunds: If a session is canceled due to low enrollment, a full refund will be issued. There will be no refunds once the session begins. Missed classes will not be refunded. Class Cancellation: ABC Spanish in Motion and SIMS may cancel class due to school closing or circumstances that are beyond our control (weather, staff illness, accidents, etc). We will post any cancellations on our website and will notify you by phone and/or email. The session will open only with a minimum level of enrollment.Please check the box beside the statement:* I agree to release from any and all liability ABC Spanish in Motion, its agents and employees for any and all personal injury and property loss or damage occasioned by, or in connection with any activity of this program. Signature*Date* Date Format: MM slash DD slash YYYY This summary order is valid for tax purposes. SIMS TAX ID 383854927PhoneThis field is for validation purposes and should be left unchanged.
