Summer Camp

Child's Full Name

Age

Address

Parent's Name

Parent's Email

Parent's Phone Number

Age

Last School Attended

Grade Attended 2020-2021

Overall Grade/GPA

Please provide a statement as to why you feel your child will benefit from this program.

I understand that Stars School Initiatives have the right to deny admittance to any student not meeting the standards of the program as it sees fit. I also agree not to hold these parties responsible in the event that my son/daughter/child engages in inappropriate conduct (including, but not limited to disruptive or volatile behavior in or out of the program, etc.) or becomes involved in any activity or with any persons not associated with Stars School Initiatives, or its scheduled program and that Stars School Initiatives, has the right to send him/her home for inappropriate conduct. I further attest that the information contained in this application is correct to the best of my knowledge. In addition, I have agreed to the policy and fee statements and agree to comply.

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