Summer Enrichment 2021

This form is for our Ribet Academy Summer Camp of 2021! Summer Camp is $250 per week (not including field trips.)

Please fill out the form to the best of your ability. If you have any questions, please contact the Front Office at (323) 344-4330 or [email protected].

Student Information

First Name*

Answer Required

Last Name*

Answer Required

Grade*

Answer Required

Birthdate*

Answer Required

T-Shirt Size*

Answer Required

Parent Information

First Name*

Answer Required

Last Name*

Answer Required

Email 1*

Answer Required

Mobile Phone*

Number Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Emergency Contact *

Grandfather - 000-000-0000, Uncle - 000-000-0000, ETC.

Answer Required

Please check the boxes of the weeks your child will be attending*

You will receive an invoice from Mrs. Tanaka

Answer Required

June 21st- June 25th

June 28th-July 2nd

July 6th - July 9th (CLOSED ON THE 5th)

July 12th - July 16th

July 19th - July 23rd

July 26th - July 30th

August 2nd - August 6th

August 9th - August 13th

August 16th - August 20th

Registration Fee*

Fee comes with a FREE T-shirt!

Answer Required

$100.00

Please fix the highlighted areas below before submitting.

Summer Enrichment 2021