Parent's First Name *

Parent's Last Name *

Cell Phone *

Email *

Address

Home Street Address *

City

State

Postal code

Child's Full Name *

Please choose yes for a sibling, but do not select yes for both children *

Yes

No

Date of birth *

Choose Program Your Child will be attending in the Fall *

Weekly Summer Program *

Week One: June 23rd - June 27th *

Attending

Not Attending

Week 2: June 30th - July 3rd (20% off regular week price) *

Attending

Not Attending

Week 3: July 7th - July 11th *

Attending

Not Attending

Week 4: July 14th - July 18th *

Attending

Not Attending

Week 5: July 21st - July 25th *

Attending

Not Attending

Week 6: July 28th - August 1st *

Attending

Not Attending

Week 7: August 4th - August 8th *

Attending

Not Attending

Week 8: August 11th - August 15th

Attending

Not Attending

Week 9: August 18th - August 22nd *

Attending

Not Attending

How Many Weeks did you sign up for? *

PLEASE NOTE: $100 Non-refundable deposit for each week enrolled will be required by all families and will be applied to your first Summer tuition payment.

Deposit to Hold Your Child's Spot

I would like you to send me an electronic invoice

I will send MSOE a check within the next 10 business days

By clicking on the submit button below, you are acknowledging and agreeing to the terms and conditions listed above and on the MSOE Summer Camp Registration page as if it was a signature..

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