Summer Camp Registration Globally Exclusive Summer Registration FormAfter submitting your registration form, you will be contacted by phone or email to confirm your students schedule. *Students will be enrolled into camps on a first come first served basis.Please enable JavaScript in your browser to complete this form.Email *Name of Parent or Guardian *Street Address, City, State, Zip *Primary Phone Number *Secondary Phone NumberEmergency Contact Name, Relation, and phone number *Student First and Last Name, MI *Student Date of Birth *MM/DD/YYYYAre there any medical conditions that we should be made aware of? If Yes, please describe below. List any known allergies, asthma, seizure history, or any other medical conditions we should be made aware of. School Attending *School DistrictAdelanto School DistrictAlta Loma School DistrictApple Valley Unified School DistrictBaker Valley Unified School DistrictBarstow Unified School DistrictBear Valley Unified School DistrictCentral School DistrictChaffey Joint Union High School DistrictChino Valley Unified School DistrictColton Joint Unified School DistrictCucamonga School DistrictEtiwanda School DistrictFontana Unified School DistrictHelendale School DistrictHesperia Unified School DistrictLucerne Valley Unified School DistrictMorongo Unified School DistrictMountain View School DistrictMt Baldy School DistrictNeedless Unified School DistrictOntario-Montclair School DistrictOro Grande School DistrictRedlands Unified School DistrictRialto Unified School DistrictRim of the World Unified School DistrictRiverside County office of EducationSilver Valley Unified School DistrictSnowline Joint Unified School DistrictTrona Joint Unified School DistrictUpland Unified School DistrictVictor Elementary School DistrictVictor Valley Union High School DistrictYucaioa-Calimesa Joint Unified School DistrictGradePre-KK1st2nd3rd4th5th6th7th8th9th10th11th12thHigher EducationWhich special services are being received at school? *N/AIEP504Gifted and TalentedOtherPlease indicate which model you prefer: *Option 1: Virtual Small Group OnlyOption 2: Virtual Small Group + 1:1 Online Tutoring (Half)Option 3: Virtual Small Group + 1:1 Online Tutoring (Full)Please indicate which camp weeks you would like to reserve: *Online Math Camp (grades 4-6)- Week 1: AdditionOnline Math Camp (grades 4-6)- Week 2: SubtractionOnline Math Camp (grades 4-6)- Week 3: MultiplicationOnline Math Camp (grades 4-6)- Week 4: DivisionOnline Math Camp (grades 4-6)- Week 5: Fractions, Decimals, and PercentsOnline Math Camp (grades 4-6)- Week 6: IntegersOnline Spanish Camp (ages 6-12)- Week 1: IntroductionsOnline Spanish Camp (ages 6-12)- Week 2: Colors and NumbersOnline Spanish Camp (ages 6-12)- Week 3: Months of the Year and SeasonsOnline Spanish Camp (ages 6-12)- Week 4: Animals and PossessionsOnline Spanish Camp (ages 6-12)- Week 5: Describing People and Things: AdjectivesOnline Spanish Camp (ages 6-12)- Week 6: Morning Routines and Classroom ObjectsOtherPlease indicate which days you would like to participate in the Virtual Small Group? *MATH- Monday & Wednesday 9amMATH- Tuesday & Thursday 9amSPANISH- Monday & Wednesday 10amSPANISH- Tuesday & Thursday 10amFor Options 2 and 3 ONLY. Choose the preferred days and times you would like to schedule your 1:1 online tutoring appointment? Please choose at least 3 different days and/or times.MondayTuesdayWednesdayThursdayFriday8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pm6:00 pmOtherHow does your student learn best?CANCELLATION POLICY I understand that due to the limited number of spaces available, I cannot change or cancel my class up to 48 hours before the class starts. I understand that if I must reschedule a class, I must call at least 48 hours in advance (rescheduling is subject to availability). 48 hour notice is defined as two business days. I understand that if I cancel within 48 hours before class starts, I will lose the class and will not be able to make up the session. Lastly, I also understand that failure to attend a class will result in the loss of the prepaid session.I Accept I Don't Accept PRE PAYMENT POLICY I understand that I must use the promotional value within the timeframe provided and that the promotional value expires. I also understand that the instructor is solely responsible for the care and quality of the advertised educational services and no claims for refund shall be valid after the completion of the purchased sessions. Lastly, I understand that fees are non-transferable between programs, other students, etc.I Accept I Don't Accept PHOTO/VIDEO RELEASE I hereby grant permission to photograph my child and to record my child's voice, performances, poses, acts, plays, and appearances, and use their picture, photograph, silhouette and other reproductions of their physical likeness and sound as part of the tentatively entitled Globally Exclusive Promos and the unlimited distribution, advertising, promotion, exhibition , and exploitation of the Globally Exclusive Promos by any method or device now known or hereafter devised in which the same may be used, and/or incorporated and/or exhibited and/or exploited.I Accept I Don't Accept How did you hear about us? *Google SearchYelp NextdoorFacebookInstagramTikTokTeacher/School PersonnelFamily/ Friend ReferralOtherSubmit