Campbell School Registration Form
Child’s Name _________________________________________________________
Date of Birth ________________________________________________________
Parents Name _____________________________________________
Address _________________________________________________
______________________________________________________________
Telephone ________________________________________________
Email _________________________________________________
Days Requested –
Tuesday/Thursday (3’s only)
9:00 – 1:00 ____ 9:00 – 3:00 ____
Monday/Wednesday/Friday –
9:00 – 1:00 ____ 9:00 – 3:00 ____
Tuesday/Wednesday/Thursday/Friday –
9:00 – 1:00 ____ 9:00 – 3:00 ____
Monday through Friday –
9:00 – 1:00 ____ 9:00 – 3:00____
Early Arrival, 8:00 a.m.
M ______ T ______ W ______ Th ______ F ______
Extended Day, 4:00 p.m.
M ______ T ______ W ______ Th ______ F ______
Extended Day, 5:00 p.m.
M ______ T ______ W ______ Th ______ F ______
Please return with $75.00 (per family) Registration Fee
$250 Deposit (applicable to tuition) due May 1st to confirm spot in class
The Campbell School
180 Blue Hill Avenue
Milton, MA 02186
Checks should be made payable to The Campbell School.
Thank you!