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2022 Summer Program Registration Form
(Lower East Side Location)
Child's First Name
Child's Last Name
Child's Date of Birth
Address
Parent's Email
List Any Allergies Your Child May Have
Parent's Name
Emergency Contact Number
Emergency Care Procedures You'd Like Us to Follow
Choose Your Program
Academic Readiness
Academic Boost
Choose Your Schedule
5 days: 09:00 am - 12:00 pm
5 days: 09:00 am - 03:00 pm
3 days: 09:00 am - 12:00 pm
3 days: 09:00 am - 03:00 pm
Others
Total Weeks Between June 27 to September 2 (start & end dates, minimum packet starts from two weeks.)
3 consecutive days you choose (for part-time schedule only)
I give permission for Talent Prep to take pictures/videos of my child during educational activities for assessment, classroom decoration, newsletter, publishing and other educational and public relation purposes.
Yes
No
I understand that a non-refundable $200 deposit per child is required in order to apply discounts and secure my child's spot and the $200 deposit will be applied towards your total tuition.
Yes
How Did You Hear About Us?
Any Extended Days?
I understand that an overdue payment fee will be applied to late payment and Talent Prep Child Development Center reserves the right to stop providing educational service to students for nonpayment.
Yes
I understand there is no refund or credit will be offered if I withdraw the 2022 Summer Program for any reason after June 21. There will be NO refunds or “makeup days” for absenteeism or vacations due to the very strict ratio regulation.
Yes
Promotion Code (only 1 code will be applied)
Submit
Please double check your info before submit!
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