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1 Child’s Name: _______________________________________________________________________________________ Birthdate: ________ / ________ / ________ Phone #: (__________) ________________________ Parent(s) Name(s): ________________________________________________________________________________ Address: _____________________________________________________________________________________________ Parent Email Address: _____________________________________________________________________________ Grade Entering: ________________________ Vacation Dates: _____________________________________________________________________________________ Is a Medical Allergy Form needed? YES or NO Do we have a Medical Form on file? YES or NO Do we have an Authorization Sheet on file? YES or NO Do we have a Field Trip form on file? YES or NO Days Attending (Please circle all that apply): Monday Tuesday Wednesday Thursday Friday Choose One Plan: ______ Half Day: $15.00/day (Up to 4.5 hours/day) ______ Full Day: $35.00/day (Pickup by 5:30 pm) Miss Gina’s Preschool and Parent Involvement Center Summer Program Application 2015

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Child’s  Name:  _______________________________________________________________________________________  

Birthdate:  ________  /  ________  /  ________                                              Phone  #:  (__________)  __________-­‐______________  

Parent(s)  Name(s):  ________________________________________________________________________________  

Address:  _____________________________________________________________________________________________  

Parent  Email  Address:  _____________________________________________________________________________  

Grade  Entering:  ________________________  

Vacation  Dates:  _____________________________________________________________________________________  

 

Is  a  Medical  Allergy  Form  needed?               YES          or        NO  

Do  we  have  a  Medical  Form  on  file?             YES          or        NO  

Do  we  have  an  Authorization  Sheet  on  file?     YES          or        NO  

Do  we  have  a  Field  Trip  form  on  file?             YES          or        NO  

 

Days  Attending  (Please  circle  all  that  apply):            

Monday                            Tuesday                              Wednesday                            Thursday                              Friday    

 

Choose  One  Plan:    

______    Half  Day:  $15.00/day  (Up  to  4.5  hours/day)    

______    Full  Day:  $35.00/day  (Pick-­‐up  by  5:30  pm)  

 

   

Miss  Gina’s  Preschool  and  Parent  Involvement  Center    Summer  Program  Application  

2015    

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Parents,    Please  keep  this  page  of  the  application  for  your  reference.  Feel  free  to  call  at  any  time  with  questions.      Morning  Agenda   Afternoon  Agenda  

7:00-­‐9:30  –  Arrival  /  Free  Time  

9:30-­‐10:00  –  Snack  

10:00-­‐10:30  –  Exercise  

10:30-­‐12:00  –  Theme  centers  

 

12:00  –  Lunch  

12:30-­‐2:00  –  Field  Trip  /  Playground  

2:00-­‐3:00  –  Outdoor  Time  /  Free  Time  

9:00-­‐5:30  –  Teacher’s  Choice  

FIELD  TRIP  SCHEDULE:      Monday,  June  22   To  Stonehedge  Bowling  Alley  (OPEN)  

$10.00  –  Includes  one  game  and  pizza  lunch.    Transportation  by  Midway  Lanes.    Leaves  MGP  at  9:30  am  –  Returns  by  11:45  am  

Tuesday,  June  23   Cinemark  Movie  Theater  Thursday,  June  25   Falls  Rock  to  visit  MGP  to  share  instrument/lesson  –  10:00  am  Friday,  June  26   To  Valley  Vista  Park  –  outdoor  play  Friday,  July  3   CLOSED  FOR  HOLIDAY  Monday,  July  6   To  Stonehedge  Bowling  Alley  (OPEN)  –  See  above  for  details.    Tuesday,  July  7   Falls  Rock  to  visit  MGP  to  share  instrument/lesson  –  10:00  am  Wednesday,  July  8   To  American  Elite  (OPEN)  

$10.00  –  Includes  gymnasium  and  transportation.    Transportation  by  Cuyahoga  Falls  bus.    Leaves  MGP  at  9:30  am  –  Returns  by  12:00  pm  

Friday,  July  10   Party  People  to  visit  MGP  for  a  Magic  Show  –  10:00  am  Monday,  July  13   To  Stonehedge  Bowling  Alley  (OPEN)  –  See  above  for  details  Tuesday,  July  14   American  Elite  to  visit  MGP  –  10:00am  Thursday,  July  16   To  Amazone  Laser  Tag  and  Jungle  Playground  (OPEN)  

$15.00  –  Includes  laser  tag  and  playground,  lunch  and  transportation.    Leaves  MGP  at  9:30  am  

Monday,  July  20   To  Stonehedge  Bowling  Alley  (OPEN)  –  See  above  for  details  Friday,  July  24   Falls  Rock  to  visit  MGP  to  share  instrument/lesson  –  10:00  am  Monday,  July  27   To  Stonehedge  Bowling  Alley  (OPEN)  –  See  above  for  details  Tuesday,  July  28   American  Elite  to  visit  MGP  –  10:00  am  Wednesday,  July  29   Party  People  to  visit  MGP  for  a  Princess/Warrior  show  –  10:00  am  Monday,  August  3   To  Stonehedge  Bowling  Alley  (OPEN)  –  See  above  for  details  Tuesday,  August  4   Falls  Rock  to  visit  MGP  to  share  instrument/lesson  –  10:00  am  Friday,  August  7   Party  People  to  visit  MGP  for  a  Magic  Show/Carnival  –  10:00  am  Monday,  August  10   To  Stonehedge  Bowling  Alley  (OPEN)  –  See  above  for  details  Tuesday,  August  11   American  Elite  to  visit  MGP  –  10:00  am  Wednesday,  August  12   Cuyahoga  Valley  Train  Ride/Critter  Adventure  (OPEN)  

$15.00  –  Includes  train  ride  and  transportation.  Bring  bag  lunch!  Leaves  MGP  at  9:30  am