The Gan Yeladim Summer Program - portlandjewishschool.com

Summer Program Registration Form - 2023
Preschool Grounded in Jewish Values & Inspired by Montessori
1. Student Information
Name*

First Name Last Name
Student´s age in the summer*
2. Parents Information

Parent filling out this form
Name*

First Name Last Name
5. Pick up Authorization

The person picking up your child will be required to present his/her photo ID. Under no circumstances will a child be released to a person who has NOT been authorized by the parent. This is for the protection and safety of your child.
Please list all authorized persons:*
6. Payment
Registration Fee $50.00 per child. *

$50
Total

$0.00

Payment*

Credit Card Paypal

Postal / Zip Code

Country

Late Pick-Up Fee $5 for every 10 minutes

I understand that my credit card on file may be used to collect late fees if I am not picking up my child on time at the end of the camp day.
Should be Empty:

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Summer Program Registration Form - 2023