Madelaine Halmos Academy Camp Inquiry Form "*" indicates required fields CompanyThis field is for validation purposes and should be left unchanged.Camper's Current Grade*VPKKindergarten1st2nd3rd4th5thInquiring about Spring or Summer Camp?*Spring CampSummer CampBothCamper Grade for 2026*Kindergarten1st2nd3rd4th5th6thCamper InformationName* First Name Last Name Gender*FemaleMaleDate of Birth* MM slash DD slash YYYY Would you like to register another camper?NoYesCamper 2 Current GradeVPKKindergarden1st2nd3rd4th5thInquiring about Spring or Summer Camp?Spring CampSummer CampBothCamper 2 Grade for 2026Kindergarten1st2nd3rd4th5thName First Name Last Name GenderFemaleMaleDate of Birth MM slash DD slash YYYY Parent InformationName* First Name Last Name Email* Emergency Contact Number*How did you hear about Madelaine Halmos Academy's Spring and/or Summer Camp??*Consent* I agree to the following:I understand that once I'm enrolled I am responsible for dropping off and picking up my student (s) within the designated camp hours and fees will be charged if I drop off earlier or pick up later than those times.Consent* I agree to the following:I understand that once enrolled, any weekly camp fees I owe (if applicable) will be billed to me via my account with the school. For questions about billing, please email Ms. Kathy at kcapobianco@jackandjillcenter.org.Full Name of Parent/Guardian Submitting Form:*Date* MM slash DD slash YYYY
