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Student Name
First
Last
Parent Name
*
First
Last
Father's Email
*
Mother's Email
*
Father's Phone number
*
Mother's Phone number
*
Week Enrolling For
July 7 – July 11
July 14 – July 18
July 21 – July 25
July 28 – Aug 1
Aug 4 – Aug 8
Aug 11 – Aug 15
Aug 18 – Aug 22
Method of Payment
Cash
Cheque
E-transfer
The following conditions are applicable to the Summer Camp at Queens Gate Academy:
• In order for a student to be accepted into the Summer Camp, the Summer Camp Enrollment Form must be completed in its entirety and signed. Full payment is required to secure the spot. • There will be no refunds for mid-month withdrawals, holidays, sick days, or any other missed days for any reason. • Extended care will be available at a rate of $100 per week. However, a late pick-up charge of $2.00 per minute will be applied after 4:00 p.m. or at any time QGA staff must remain beyond established hours to care for a student due to late pick-up. I/We have read, understand, and agree to the terms of Queens Gate Academy for the enrollment of our child for Summer Camp. I/We understand that the deposit is non-refundable.
Phone
Submit
39089
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