PLP Summer - Congregation Kol Ami

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Home > Education > Playful Learning Preschool > Register for Summer 2024

Apply for Summer Camp 2024!
Please use the form below to apply for and pay your $100 deposit to hold your spot at the Playful Learning Preschool at Kol Ami Summer Camp. Please contact Kim Saul, Preschool Director, with any questions.

Go back to the Playful Learning Preschool Website

Billing Information

* First Name

* Last Name

* Email

* Phone

* Address

* City

* State

* ZIP Code

Child Information

* Child's Full Name

Name Child Goes By

* Gender

* Date of Birth

* Age

Any know allergies? If yes, please list them.

I give permission for my child's photographs to be shown on PLP's website, social media, newsletters, or any other publication.

Parent/Guardian Information

* Parent/Guardian 1 Name

Home Phone #

Email Address

Cell Phone #

Employer

Work Phone #

* Parent/Guardian 2 Name

Home Phone #

Email Address

Cell Phone #

Employer

Work Phone #

Home Information

* Child Lives With

If "Other," Please Provide Details

Sibling's Names and Ages

Emergency Contacts

* Name/Relationship

* Cell Phone #

* Name/Relationship

* Cell Phone #

Schedule & Deposit

* Please Indicate Which Schedule You Are Applying For

Full-Day, Monday – Friday, 8:30am – 3:00pmHalf-Day, Monday – Friday, 8:30am – 12:00pmAftercare, Monday – Friday, 3:00pm – 5:00pm

* By checking this box you are agreeing to pay a $100 deposit to hold your child's place.

By checking this box you are agreeing to pay a $100 deposit to hold your child's place.

Additional Comments

Fri, July 26 2024
20 Tammuz 5784

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Fri, July 26 2024 20 Tammuz 5784

CONGREGATION KOL AMI
2425 East Heritage Way, Salt Lake City, Utah 84109
PHONE 801-484-1501 • FAX 801-484-1162 • info@conkolami.org

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