Summer Fun Enrollment Form

Summer Fun 2019 is currently full. Submitting the enrollment form below will add your child/ren to our Summer Fun wait list.

There are two (2) Summer Fun Enrollment Forms:
1 - Summer Fun Registration Form
2 - Child Health Report Form

1 Current: Child Information
2 Summer Fun Registration Schedule Payment Agreement
3 Parental Consent and Emergency Contact Form
4 Expectations Checklist
5 Minor Media Release
6 Final Payment Agreement
7 Complete

Fill All Required Fields

If a field is required, MLEDP is likely required to collect it. If the information does not apply to you, please enter N/A in the field.

Child's Name

First

Middle

Last

Birth Date

Re-order	Month	Date	Year	Weight	Operations
	Month	Date	Year Year: Year	Item weight

Gender

Male

Female

Age

Child's Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Home Phone Number for Child

Grade Completed

tes

Additional Rate and Calendar Information

A typical day is 11.5 hours of care.

A minimum of 10 days enrollment is required.

Parents agrees to pay a contracted fee each month, based upon the child’s scheduled attendance per week, regardless of illness of the child or other unanticipated absence from child care including vacations.

MLEDP provides transportation for scheduled Summer Fun Activities at no additional cost.

The following items are billed as they occur.

Late Pick Up Fee:
$10.00 for every 15-minute increment beyond closing time (6:30 p.m.).
Late Payment Fee:
Payments are due the first day of every month. A late fee of 5% of the account balance will be assessed to accounts, if payment arrives after the 5th day of the month.
Change of Schedule Fee - $25.00
After May 15 your scheduled child care is set for the summer. Scheduling additional child care would be subject to availability and a schedule adjustment charge of $25.00. As always, days may be swapped within a calendar week without charge, if space is available.