MOUNT OLIVE LUTHERAN PRESCHOOL
                       June 27 - July 1        Vacation Bible School                  $50.00/ 1 child
                                               “Discovery on Island Adventure!”       $80.00/ 2 siblings
                                                                                      $110.00/ 3 siblings
                       July 5 - July 8         “Stars & Stripes”                      $140.00
                       July 11 - July 15       “Pirates & Mermaids”                   $175.00
                       July 18 - July 22       “Dinosaur Stem”                        $175.00
                       July 25 - July 29       “Water World”                          $175.00
                            SCHOLARSHIPS AVAILABLE FOR VBS - please see the Director for more information.
                    STUDENTS NOT ENROLLED AT MOUNT OLIVE MUST HAVE A COMPLETED ENROLLMENT PACKET TO
                                  ATTEND. CHILDREN MUST BE  3-5 YEARS OLD AND POTTY TRAINED.
                CAMP HOURS: 8:30AM - 12:00PM  
                    ● Each camper will need a backpack with a complete change of clothes, a water 
                        bottle, a snack, and sunscreen each day. Please make sure all belongings are 
                        labeled with the camper’s name. 
                CAMP FEES: 
                    ● $50.00 Registration per weekly camp, will credit towards balance. 
                    ● Registration fees must be paid at the time of registration and are non-refundable.
                    ● Fees can be paid by Electronic Funds Transfer, check, or cash. No debit or credit card 
                        payments.
                    ● Camp fees will be due the Friday before each camp.
                    ● There are no reimbursements for cancellations or days missed.
                     ● VBS
                     ● STARS AND STRIPES
                     ● PIRATES AND MERMAIDS
                     ● DINOSAUR STEM
                     ● WATER WORLD
                 CAMP REGISTRATION FORM (One form per child)
                 *Student First Name: _________________    *Student Last Name:_________________________   
                 Nickname: ______________________________    Age:  _______              Gender:  Male    Female
                 Allergies: _______________________________________________________________________
                 What school do you currently attend?:_______________________________________________
                 *Parent Name (first and last): ______________________________________________________    
                 *Address: ______________________________________________________________________   
                 *City: ____________________________*State:______*Zip: ___________   
                 *Email: _______________________________________________________________________  
                 *Home/Cell Phone Number:_____________________________  
                 Emergency Contact: _______________________________Emergency Phone: ______________
                 Alternate Pickup (first and last name): ______________________________________________
                 Alternate Pickup Phone: _________________________________________________________         
                 Medical Release: I give my permission for the Summer Camp staff to administer basic first aid to my 
                 child (named above) in the event of an injury. I understand that the Summer Camp staff will contact 
                 emergency services in the event of a significant injury and all expenses for such emergency services will 
                 be paid by me.
                 Photo Release: I hereby grant Mount Olive Lutheran Preschool permission to copyright and use 
                 photographs/videos taken at Summer Camp of the minor designated above in any manner or form for 
                 any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished 
                 product or written copy, that may be used in conjunction therewith, or the use to which it may be 
                 applied.
                 Permission to Attend: I give permission for my child (named above) to attend the Summer Camp listed 
                 above. I understand that the information I give for this registration will only be used by Mount Olive 
                 Lutheran Preschool, and that all registration information will be removed from the hosting site by 
                 September of this year.
                                Mount Olive may charge my preschool account on file for payment.
                 Parent Signature ___________________________________            Date ___________________