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Registration Form for Summer Programs

Grades K-5 · Weeks available July 6 – August 14

Student's First Name*

Student's Last Name*

Student Grade in SY 2026-27*

Please select appropriate grade category for your student based on what grade they will start in the fall.

Parent's / Guardian's First Name*

Parent's / Guardian's Last Name*

Parent's /Guardian's Contact Number*

Parent's /Guardian's Email*

Emergency Contact First Name*

Emergency Contact Last Name*

Emergency Contact Number*

Address*

Address Line 2

Pin/Postal Code*

City*

Week Selection*

July 6-10

July 13-17

July 20-24

July 27-31

Aug 3-7

Aug 10-14

Session Type*

Full Day Camp 9am-4pm ($499)

Extended Day Camp 9am-6pm ($599)

Morning Half Day 9am-12pm ($299)

Afternoon Half Day 1pm-4pm ($299)

Extended Afternoon 1pm-6pm ($399)

Photo/Recording Consent*

Yes

No

I have read and agree to the Attendance Policy

I have read and agree to the Cancellation

I have read and agree to the Medical

I have read and agree to the Privacy Policy

A 3.99% processing fee applies to all registrations. Questions? Call (571) 207-8373

Quick Links

Contact Info

(571) 207-8373

contact.us@learningwithlumi.com

Privacy Policy

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