Summer Short

STEP TWO
Short Form | Summer 2021
*** PLEASE COMPLETE ONE OF THESE FORMS ONLY AFTER YOU HAVE PURCHASED YOUR SUMMER CAMP WEEKS. ***
YOUR CLASSES WILL ONLY BE RESERVED VIA PAYMENT.
SUBMITTING FORMS PRIOR TO PAYMENT DOES NOT GUARANTEE YOUR CHILD A SPOT.

If your child participated in the recent spring or fall classes, and nothing has changed with your child’s information,
medical history or emergency contact info, please fill out this first abbreviated form. If your student hasn't participated in the most recent
semester or you have had a change in information, please fill out the long form below.

CAMP WEEKS & FEES:

June 7 - 11: $325
June 14 - 18: $325
June 21 - 25: $325
June 28 - July 2: $325
July 12 - 16: $325
July 19 - 23: $325

CAMP DETAILS:

Open to Kids 8 to 18
Fees are per Week per Child
Camps are 9:00 a.m. - 3:00 p.m.
Camps are Monday - Friday

CAMP LOCATION:
La Mariposa Montessori School
18 Puesta Del Sol
Santa Fe, NM 87508

* Indicates required field

Student Name 1 *

First

Last

P1: Date of Birth *

P1: Gender *

PLEASE SELECT WHICH WEEKS YOUR CHILD WOULD LIKE TO ATTEND:

REFUND POLICY (PLEASE READ CAREFULLY): Refunds will be given for cancellations made no less than 7 days in advance of the program start-date, minus a 20% administration fee. Any cancellation made less than 7 days prior to the first day of class results in forfeiture of the registration fee. I understand that if my student misses a class, there are no refunds and the student may not attend another day as a make-up session. *

Yes, I have read the refund policy and agree to the above terms.

* Space is limited and there are 8 participants per class NO EXCEPTIONS.
We are happy to wait list your child and notify you of any opening/ cancellations. Clamps will be filled on a first-come/ first serve basis.

I verify that no pertinent information has changed since the previous semester regarding my child's health and safety. *

I verify no critical information has change.

Participant(s) Name(s) *

Parent / Guardian Name *

Date *

*PLEASE NOTE WHEN SUBMITTING REGISTRATION FORM TO REFRESH THE PAGE AFTER YOU HAVE CORRECTED ANY RED BLOCKS*

Submit Registration

Contact ADW
Mailing Address:
P.O. Box 31027
Santa Fe, NM 87594

Physical Address:
1590 San Mateo Lane
Santa Fe, NM 87505

Phone & Fax:
505.986.9748
fax: 505.989.9640
toll free: 866.986.3489

Office Hours:
M-Th: 9:30 a.m. – 5 p.m.
Friday: 11:00 a.m. – 2:30 p.m.

Apply for a Service Dog:
Read our FAQ and access our application.

© 2016 Assistance Dogs of the West. All Rights Reserved. Website & Hosting | The GB
Assistance Dogs of the West is a 501(c)(3) tax-exempt organization.

Please note: If ADW has received sufficient funds to cover a specific donation category within a fiscal year, your donation will be used where it is needed most.