Summer at Temple Beth David Shalom Corner Early Learning Center Application - Form - Temple Beth David

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Summer at Temple Beth David Shalom Corner Early Learning Center Application

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Welcome to Summer at Shalom Corner 2022! Join us for fun in the sun, picnics, nature explorations, water play, and additional time with familiar and new friends and teachers.

Enrollment will be confirmed only with written verification from the Director. Sibling and temple membership discounts will apply and will be added to your account. All payments for summer programs are due in full by June 1st, 2022.

Student Information

* Today's date

* Child's first name

* Last name

Nickname

* Birthday

* Parent's first name

* Parent's last name

* Phone number to call first

* Primary email address

* Primary language spoken at home

* Are you a member of Temple Beth David?

Please Select OneYesNoNot yet, but I am interested in learning more.

* Is your child new to Shalom Corner Early Learning Center?

Please Select OneMy child is a returning Shalom Corner student.My child is new to Shalom Corner and is already registered for Fall 2022.My child is new to Shalom Corner and is not registered for Fall 2022.If your child is new to Shalom Corner, you will receive additional forms to complete as required by the Massachusetts Department of Early Education and Care.

I would like my child to attend Session 1: July 5-8

I would like my child to attend Session 1: July 5-8

Session 1 Options

N/ASession 1 (4 days, 8 am to 1 pm)Session 1 (4 days, 8 am to 4 pm)

I would like my child to attend Session 2: July 11-22

I would like my child to attend Session 2: July 11-22

Session 2 Options

N/ASession 2 (5 days, 8 am to 1 pm)Session 2 (5 days, 8 am to 4 pm)Session 2 (M/W/F, 8 am to 1 pm)Session 2 (M/W/F, 8 am to 4 pm)Session 2 (T/Th, 8 am to 1 pm)Session 2 (T/Th, 8 am to 4 pm)

I would like my child to attend Session 3: July 25-Aug 5

I would like my child to attend Session 3: July 25-Aug 5

Session 3 Options

N/ASession 3 (5 days, 8 am to 1 pm)Session 3 (5 days, 8 am to 4 pm)Session 3 (M/W/F, 8 am to 1 pm)Session 3 (M/W/F, 8 am to 4 pm)Session 3 (T/Th, 8 am to 1 pm)Session 3 (T/Th, 8 am to 4 pm)

I would like my child to attend Session 4: Aug 8-19

I would like my child to attend Session 4: Aug 8-19

Session 4 Options

N/ASession 4 (5 days, 8 am to 1 pm)Session 4 (5 days, 8 am to 4 pm)Session 4 (M/W/F, 8 am to 1 pm)Session 4 (M/W/F, 8 am to 4 pm)Session 4 (T/Th, 8 am to 1 pm)Session 4 (T/Th, 8 am to 4 pm)

* Click to pay the $50 non-refundable application fee. The payment screen will appear after you click "submit" below.

Click to pay the $50 non-refundable application fee. The payment screen will appear after you click "submit" below.

* My electronic signature below represents the commitment to paying the summer's tuition in full by June 1, 2022 as indicated by my program selection(s) on this application.

My electronic signature below represents the commitment to paying the summer's tuition in full by June 1, 2022 as indicated by my program selection(s) on this application.

PARENT NAME

Thu, February 2 2023 11 Sh'vat 5783

Temple Beth David

7 Clapboardtree Street

Westwood, MA 02090

781-769-5270

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