Culpeper UMC Preschool

STUDENT PROGRAMS

CUMC SUMMER CAMP APPLICATION FOR ADMISSION

You may register directly online by filling out the following form. When you click submit, you will be directed to our online bill pay where you can remit payment for the registration fee.

If you prefer, you may download a paper Application for Admission by clicking here. Please return this application with a non-refundable enrollment fee of $75.00. Make your check payable to Culpeper United Methodist Church and attach it to this form.

Culpeper UMC Preschool does not discriminate against any student on the basis of race, creed, or national origin.

Child Enrollment/ Information Record

First Name

Date of Birth

Child's Middle Name

Gender

Last Name

Child's T-Shirt Size

Please check desired camp week (student must be age of desired class by June 1, of the current year, and fully potty trained.)

Camp Week

Camp Theme

Registration & Camp Fee Due

Days Attending

June 7 - 11

Nature Week

May 24

M 6/7

T 6/8

W 6/9

Th 6/10