Summer at MLS offers children aged 18 months to 5 years a fun and engaging environment filled with activities like soccer, art, music, theater, science, and more. With plenty of outdoor play, water activities, and nutritious snacks, the program encourages curiosity and independence in a safe and supportive space. Experienced staff ensure a secure and nurturing environment where children can make friends, explore new interests, and have a blast. Early Enrollment: Feb. 2nd - Feb 28th at noon Regular Enrollment: Feb. 28th at noon - May 1st at 6:00pm Last Call Prices (based on availability): Starts May 2nd at 9:00am Enrollment How did you hear about Summer at MLS 1. Parents Information Parental Marital Status* MarriedSeparatedDivorcedFather DeceasedMother DeceasedSingle Parent I am the Child's* FatherMotherLegal Gaurdian Parent A: Name* First Name Last Name Parent A: E-mail* Parent A: Phone Number* Home Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Background Jewish by birthJewish by conversionNot Jewish Parent A: Name* First Name Last Name Parent A: Phone Number* Parent A: E-mail* Parent's Background Jewish by birthJewish by conversionNot Jewish Parent B: Name* First Name Last Name Parent B: Phone Number* Parent B: E-mail* Other Parent's Background Jewish by birthJewish by conversionNot Jewish 2. Children’s Information Number of children being registered* Child 1 Full Name* First Name Last Name Does your child currently attend My Little School?* YesNo Child 1 Current MLS Class Name* My Big ClassLavanKacholKeshetSagolAdomTzahov Birth Date* Month Day Year Gender* Is your child adopted? YesNo *All prices shown are Early Bird Special Prices Caregiver Track *WAITLIST* 9:30am - 11:30am. This track includes a $300 non-refundable deposit as part of the total rate. Full Session $1,603Week 1 June 5 - June 13 $493Week 2 June 16 - June 20 $370Week 3 June 23 - June 27 $370Week 4 June 30 - July 3 $370 Track A *WAITLIST* 9:00am - 12:00pm. This track includes a $700 non-refundable deposit as part of the total rate. Full Session $3570Week 1 June 5 - June 13 $1190Week 2 June 16 - June 20 $850Week 3 June 23 - June 27 $850Week 4 June 30 - July 3 $680 Track B * 8:55am - 2:00pm. This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,095Week 1 June 5 - June 13 $1365Week 2 June 16 - June 20 $975Week 3 June 23 - June 27 $975Week 4 June 30 - July 3 $780 Track C* 8:45am - 3:00pm. This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,410Week 1 June 5 - June 13 $1470Week 2 June 16 - June 20 $1050Week 3 June 23 - June 27 $1050Week 4 June 30 - July 3 $840 Is your child currently receiving any services or have an Individualized Education Program (IEP)? Write "N/A" if this does not apply Medical Information Child 1: Pediatrician* First Name Last Name Phone Number* Area Code Phone Number Insurance Does your child have any allergies (e.g., medications, foods, etc.)? Please provide details.* If yes, please email us at [email protected] to schedule a meeting to discuss your child's allergy plan. Does your child have an EpiPen?* YesNo Are there any medical, developmental or emotional conditions we should be aware of?* Please include any services or IEPs your child is receiving I give permission for my child to receive Children's Tylenol, Motrin, or a similar medication if needed* YesNo Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain Do you agree to inform us of any updates to your child's medical information?* We will rely on your child's medical information that we have on file for the 2024-2025 school year, unless otherwise noted. Yes, I take full responsibility to update the Summer at MLS admin team with the most accurate medical information regarding my child. What language(s) are spoken at home?* Child 2 Full Name* First Name Last Name Does your child currently attend My Little School?* YesNo 2nd Child Current MLS Class Name* My Big ClassLavanKacholKeshetSagolAdomTzahov Birth Date* Month Day Year Gender* Is your child adopted? YesNo Caregiver Track *WAITLIST* 9:30am - 11:30am. This track includes a $300 non-refundable deposit as part of the total rate. Full Session $1,603Week 1 June 5 - June 13 $493Week 2 June 16 - June 20 $370Week 3 June 23 - June 27 $370Week 4 June 30 - July 3 $370 Track A *WAITLIST* 9:00am - 12:00pm. This track includes a $700 non-refundable deposit as part of the total rate. Full Session $3570Week 1 June 5 - June 13 $1190Week 2 June 16 - June 20 $850Week 3 June 23 - June 27 $850Week 4 June 30 - July 3 $680 Track B * 8:55am - 2:00pm. This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,095Week 1 June 5 - June 13 $1365Week 2 June 16 - June 20 $975Week 3 June 23 - June 27 $975Week 4 June 30 - July 3 $780 Track C* 8:45am - 3:00pm. This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,410Week 1 June 5 - June 13 $1470Week 2 June 16 - June 20 $1050Week 3 June 23 - June 27 $1050Week 4 June 30 - July 3 $840 Medical Information Child 2: Pediatrician* First Name Last Name Phone Number* Area Code Phone Number Insurance Does your child have any allergies (e.g., medications, foods, etc.)? Please provide details.* Please email us at [email protected] to schedule a meeting to discuss your child's allergy plan. Does your child have an EpiPen?* YesNo My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise* YesNo Are there any medical, developmental or emotional conditions we should be aware of?* Please include any services or IEPs your child is receiving. Is your child currently receiving any services or have an Individualized Education Program (IEP)? Write "N/A" if this does not apply Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain Do you agree to inform us of any updates to your child's medical information?* We will rely on your child's medical information that we have on file for the 2024-2025 school year. Yes, I take full responsibility to update the Summer at MLS admin team with the most accurate medical information regarding my child. What language(s) are spoken at home?* Child 3 Full Name* First Name Last Name Does your child currently attend My Little School?* YesNo 3rd Child Current MLS Class Name* My Big ClassLavanKacholKeshetSagolAdomTzahov Birth Date* Month Day Year Gender* Is your child adopted? YesNo Caregiver Track *WAITLIST* 9:30am - 11:30am. This track includes a $300 non-refundable deposit as part of the total rate. Full Session $1,603Week 1 June 5 - June 13 $493Week 2 June 16 - June 20 $370Week 3 June 23 - June 27 $370Week 4 June 30 - July 3 $370 Track A *WAITLIST* 9:00am - 12:00pm: This track includes a $700 non-refundable deposit as part of the total rate. Full Session $3570Week 1 June 5 - June 13 $1190Week 2 June 16 - June 20 $850Week 3 June 23 - June 27 $850Week 4 June 30 - July 3 $680 Track B * 8:55am - 2:00pm: This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,095Week 1 June 5 - June 13 $1365Week 2 June 16 - June 20 $975Week 3 June 23 - June 27 $975Week 4 June 30 - July 3 $780 Track C* 8:45am - 3:00pm: This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,410Week 1 June 5 - June 13 $1470Week 2 June 16 - June 20 $1050Week 3 June 23 - June 27 $1050Week 4 June 30 - July 3 $840 Is your child currently receiving any services or have an Individualized Education Program (IEP)? Write "N/A" if this does not apply Medical Information Child 3: Pediatrician* First Name Last Name Phone Number* Area Code Phone Number Insurance Does your child have any allergies (e.g., medications, foods, etc.)? Please provide details.* If yes, please email us at [email protected] to schedule a meeting to discuss your child's allergy plan. My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise* YesNo Are there any medical, developmental or emotional conditions we should be aware of?* Please include any services or IEPs your child is receiving Does your child have an EpiPen?* If "Yes" Please email us at [email protected] to book a meeting to discuss your child’s allergy plan. YesNo Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain Do you agree to inform us of any updates to your child's medical information?* We will rely on your child's medical information that we have on file for the 2024-2025 school year. Yes, I take full responsibility to update the Summer at MLS admin team with the most accurate medical information regarding my child. Language(s) spoken at home?* Child 4 Full Name* First Name Last Name Does your child currently attend My Little School?* YesNo Current MLS class name* My Big ClassLavanKacholKeshetSagolAdomTzahov Birth Date* Month Day Year Gender* Is your child adopted? YesNo Caregiver Track *WAITLIST* 9:30am - 11:30am. This track includes a $300 non-refundable deposit as part of the total rate. Full Session $1,603Week 1 June 5 - June 13 $493Week 2 June 16 - June 20 $370Week 3 June 23 - June 27 $370Week 4 June 30 - July 3 $370 Track A *WAITLIST* 9:00am - 12:00pm: This track includes a $700 non-refundable deposit as part of the total rate. Full Session $3570Week 1 June 5 - June 13 $1190Week 2 June 16 - June 20 $850Week 3 June 23 - June 27 $850Week 4 June 30 - July 3 $680 Track B * 8:55am - 2:00pm: This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,095Week 1 June 5 - June 13 $1365Week 2 June 16 - June 20 $975Week 3 June 23 - June 27 $975Week 4 June 30 - July 3 $780 Track C* 8:45am - 3:00pm: This track includes a $700 non-refundable deposit as part of the total rate. Full Session $4,410Week 1 June 5 - June 13 $1470Week 2 June 16 - June 20 $1050Week 3 June 23 - June 27 $1050Week 4 June 30 - July 3 $840 Is your child currently receiving any services or have an Individualized Education Program (IEP)? Write "N/A" if this does not apply Medical Information Child 4: Pediatrician* First Name Last Name Phone Number* Area Code Phone Number Insurance Does your child have any allergies (e.g., medications, foods, etc.)? If yes, please provide details.* My child is permitted to be given Children's Tylenol, Motrin or similar should the need arise* YesNo Are there any medical, developmental or emotional conditions we should be aware of?* Write "N/A" if this does not apply Does your child have an EpiPen?* If "Yes" Please email us at [email protected] to book a meeting to discuss your child’s allergy plan. YesNo Does your child have a medical, developmental or emotional condition that camp should be aware of? If yes, please explain* You agree to make us aware of any updates to your child's medical information* Yes, I take full responsibility to update the Summer at MLS admin team with the most accurate medical information regarding my child. Language(s) spoken at home?* If you have additional children, please contact us. Will you be sending one or more of your children to My Little School for the FIRST TIME in the Fall of this year? 1st Child Full Name First Name Last Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year 2nd Child Full Name First Name Last Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year 3rd Child Full Name First Name Last Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year 3. Pick-Up Authorization Who is authorized to pick up your child(ren) from camp?* Full name, contact number, relation to child Name / Number / Relation to child 4. Emergency Contacts Who should the Summer at MLS admin team contact in an emergency if both parents cannot be reached?* Full name, contact number, relation to child Name / Number / Relation to child Click to agree to the terms described* I hereby give consent to the administration of Summer at My Little School, a division of Chabad of Tribeca, to take whatever medical measures they deem necessary, at my expense, for my child in the event of a medical emergency. I understand that, when possible, every effort will be made to contact a parent/guardian or emergency contact before My Little School undertakes such a decision E-Signature of Parent or Guardian* Date* Month Day Year 5. Payment Information Total $0.00 Payment* Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country General comments 6. Terms and Conditions By signing my name in the box below, I agree to the following terms: I hereby permit my child(ren) to participate in all activities at Chabad of Tribeca, on-site, off-site and on any trips and/or swimming activities. I release Chabad of Tribeca and all individuals from any liability arising out of any injury to my child(ren). I understand that my child(ren) may be dismissed during a camp day, due to illness, at the discretion of the camp, and I agree to abide by the director’s decision. In the event of a medical or surgical emergency, I grant permission to the physician designated by Chabad of Tribeca to hospitalize, secure proper treatment for and order injections, anesthesia or surgery for my child(ren). Furthermore, I understand that payment for medical services is solely the family’s responsibility. PARENTAL CONSENT: I hereby give consent for my child to participate in all activities at Chabad of Tribeca both on and off site, swimming activities, trips, transportation to and from trips etc., unless I advise you otherwise in writing. PAYMENT AND CANCELLATION: A health form, completed by your doctor, must be on file before your child can start Summer at MLS. Summer at MLS is not responsible for providing make-ups or issuing refunds for camp days as a result of scheduling conflicts, illness, emergencies, or other events beyond our control. A camp deposit of $700 is non-refundable once you have registered for camp. If a child is withdrawn from camp before the end of the session by parents or guardians, no refund will be given. There is no pro-rated fee for campers arriving after the start of a week or leaving before its completion. Early bird registration refunds will not be provided after 3/14/2025, and no regular registration refunds will be given after 04/10/2025. By signing my name in the box below, I agree to pay the full tuition for the period indicated on this enrollment form. I acknowledge that no tuition refunds for early bird registrations will be processed after noon on 03/14/2025. All early bird registrations are deemed final as of noon on 03/14/2025. Additionally, I acknowledge that no tuition refunds for full price tuition will be accommodated after 04/10/2025, and all full price tuition registrations are finalized as of noon on 04/11/2025. DISMISSAL OF CAMPER: Parent fully understands and agrees that the Camp reserves the right to dismiss, in its sole discretion, any Camper whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interests of the Camp or fellow campers or who violates camp rules and regulations. IMAGES, ETC.: Permission is hereby given to use in promoting the Camp and in other ventures directly relating to the Camp (i) digital, photographic and video images or likenesses of camper; audio of camper; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by camper or originating from Camp or from a Camp-related activity. INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless Chabad of Tribeca and its officers, servants or assignees from any liability concerning our child’s involvement in Chabad of Tribeca and further agree that the use of any premises during the Chabad of Tribeca camp day is made at the risk of the registrant. I have read and agreed to all of the terms and conditions in this Application Form. Agreement* I agree to the above terms and conditions E-Signature of Parent or Guardian* Date* Month Day Year Should be Empty: Submit This page uses TLS encryption to keep your data secure.
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