2017 ES Summer School Brochure

2017 LBES SUMMER SCHOOL & ENRICHMENT
REGISTRATION FORM
Student’s Name (Print) ________________________________________________
Grade level in the Fall
Address ____________________ City _
Age
Lanakila Baptist Schools
ELEMENTARY DIVISION
94-1250 Waipahu Street Waipahu, Hawaii 96797
(808) 677-0731
Phone
parent email _________________________________
Emergency contact: _______________________ _________________________
Emergency contact #: ____________________
_______
Any medical conditions or food allergies? YES
If yes, please complete medical forms
NO
Signature of Parent/Guardian
_____
Morning Care needed: YES ($232 for entire session) NO
Desired Plan:
PLAN A (HALF DAY)- $800/ sibling discount $600
PLAN B (FULL DAY)- $1,000/ sibling discount $800
Office Use Only
& Enrichment 2017
Total LBES Summer School Investment:
Plan: A B $____________ Morning Care option $232
Registration fee received ___/___ $__________
Tuition received ___/___ $__________ Cash/Ck#_______
T-Shirt Size: ______________________________________
Early Registration $100
Mar. 20- April 28, 2017
Open Registration $150
May 1- June 2, 2017