Student Name:
June15 –June 19
M T W TH F
June22 –June 26
M T W TH F
June 29 – July 3
M T W TH F
July 6 – July 10
M T W TH F
July 13 – July 17
M T W TH F
July 20 – July 24
M T W TH F
July 27 – July 31
M T W TH F
Aug 03 – Aug 07
M T W TH F
Aug 10 – Aug 14
M T W TH F
Aug 17 – Aug 21
M T W TH F
Gender: _______
Grade in Fall: ______
Morning Drop off 8:00-9:00
Lunch / Movie
12:30-1:00 Nap/Building/Reading
Morning Camp9:00-11:00
11:30-12:30
Afternoon Camp 1:00-3:00
Mad Science
--Robot Recruit*
$5/day or
Camp Jr. Ocean Explorer
Little Bits—
Engineering Space Science
Writing The Future
& Future City Design
Digital Photography
The power of Self Defense
-- Martial Arts
Adventure in Programming
-- Scratch (MIT)
Chess &Chinese Chess
Fundamentals/VBS
Wild Encounters
—Zoo Education
Creative Performing Arts-You
Got Talent/Beach & Pool Party
$20 / week
$5/day or
$20/ week
$5/day or
$20/ week
$5/day or
$20/ week
$5/day or
$20/ week
$5/day or
$20/ week
$5/day or
$20/ week
$5/day or
$20/ week
$5/day or
$20/ week
$5/day or
$20/ week
D.O.B: ____/ ____/ ________ Phone:
Little Bits
-- Science ,Engineering Art
Basketball/Multi Sports
Musical Triple Theater
-- Singing, Dancing & Acting
Health & Wellness Camp
The World’s Greatest Invention
Art Appreciation –
Passport To Art
Comic Book Creation Camp
3:00-3:30 Break& Snack
3:30-4:30-6:30
Short
Day
Half
Day
Lunch
Cost
Math & Chinese/Spanish
& Craft & Free Activities
Math & Chinese/Spanish
& Craft & Free Activities
Math & Chinese/Spanish
& Craft & Free Activities
Math & Chinese/Spanish
& Craft & Free Activities
Math & Chinese/Spanish
& Craft & Free Activities
Math & Chinese/Spanish
& Craft & Free Activities
Math & Chinese/Spanish
& Craft & Free Activities
Cooking Journey around the
world
Math & Chinese/Spanish
Lego Robotic —
Adventures in Engineering
Math & Chinese/Spanish
Creative Performing Arts-You
Got Talent/Beach & Pool Party
Math & Chinese/Spanish
& Craft & Free Activities
& Craft & Free Activities
& Craft & Free Activities
Programs:
Sub Total

Full Day Program (8:00am-6:30pm) $255/week or $55/day

Short Day Program (8:00am-3:00pm or 12:30pm-6:30pm) $210/week or $45/day
or 20% off $210/week with enrollment in our morning or afternoon Computer Programming & Design Camp in the same week

Full
Day
/
Half Day Program (8:00am-12:00pm) or (12:30pm-3:30pm) or (3:30pm-6:30pm) $165/week or $35/day
Registration Fee
$50
Material Fee
$50
Discount
Total
or 20% off $165/week with enrollment in our morning or afternoon Computer Programming & Design Camp in the same week
* Mad Science requires whole week enrollment
-Please circle attending days, lunch option and one language class when you sign up.
858.381.0128
-- Upon request, we will provide group lessons of piano, violin, swimming, or more.
www.inGenius.us
Tuition
Student Name:
Home Address:
Parent Name:
Emergency Contact #1:
Emergency Contact #3:
Special Medical Concerns:
Gender: _______
/
Phone:
Phone:
Grade in Fall: ______
D.O.B: ____/ ____/ ________
Phone:
Email:
/
Emergency Contact #2:
/
Phone:
Allergy:
Discounts:
• Early Registration discounts by May 3rd, 2015:
o
$50 Registration Fee will be waived by May 3rd, 2015
o
Get 5% off for early registration by May 3rd, 2015 with Six Full weeks of Full Day Program
• Get 10 weeks of lunches for free with 10 Full weeks of Full Day Program
 5% Sibling Discount for the 2nd and 3rd child with lower tuition amount
Photo/Media Release
I,
, hereby give permission to the inGenius
to use
’s name and photographs or other
media for display on the inGenius website , inclusion in inGenius
publications, brochures, newspaper broadcast and any other form of
communication.
Enrollment Agreement:
1. All the programs, schedules, and fees are subject to change without notice.
2. $50 Registration Fee for new students only. Material fees are $50, per student, upon enrollment.
3. The registration fee and materials fee are non-refundable. There is a $50 cancellation fee two weeks prior to the camp’s start date. There are no refunds if canceled less than two
weeks prior to the camp’s start date.
4. Enrollment will be subject to cancellation if payment is not received within 5 business days upon registration request.
5. Please DO NOT allow students bring valuables to inGenius camp. We are not responsible for lost or damaged items.
6. Parents/legal guardians or authorized personnel are allowed to pick up your children anytime during our business hours. The signature and the sign out time are required on the daily
Sign in/Out Sheet. Identification is required at the front desk for any non-authorized guardian.
7. Parents/legal guardians hereby agree that this is a contract that extends from the time of registration until the end of the camp session, August 21, 2015. Parents/legal guardians are
legally obligated to pay the tuition for the session in which their child is registered. Parents/legal guardians agree that there are no allowances made for absences.
8. In case of sudden injury or illness, parents/legal guardians give authority to any hospital or doctor selected by the inGenius to render immediate aid as may be required at the time for
the children's health and safety. Parents/legal guardians understand that medical expenses are their own responsibility.
9. Parents/legal guardians hereby assume all risks (injury or illness) for their children and family members that may occur during participation in any activity or use of facilities owned or
rented by the inGenius. Parents/legal guardians hereby agree to in no way hold the management of the INGENIUS, its agents or employees liable for lost or damaged belongings or
injury that the child may sustain while involved at the inGenius.
Parent/Legal Guardian Signature:
Date:
858.381.0128
www.inGenius.us