Summer Recreation Registration - Village of Florida

Any Florida Union Free School District child entering 1^st grade through 6^th grade only in the 2023-2024 school year may attend. Program begins 6/26 from 9am-3pm at Golden Hill. Your child is not considered fully registered without vaccination information. The Village reserves the right to change locations if necessary.

Contact info@villageoffloridany.org . Summer Recreation sign up below. Thank you for your patience.

Child’s Name:(required)

Child’s age:(required)

MaleFemale

Grade (entering the 2023 –2024 school year. Must be entering 1st grade or later) (required)

WhiteBlack or African American Hispanic or LatinoAmerican Indian or Alaskan NativeAsianNative Hawaiian or other Pacific IslanderTwo or More Races***info for funding purposes only.

Parent/Guardian’s Name:(required)

Address: (required)

Your Telephone Number (required)

Your cell Number (required)

Emergency Contact:(required)

Emergency Contact Telephone Number (required):

Your Email (required)

PLEASE ATTACH A COPY OF YOUR CHILD’S CURRENT VACCINATIONS. CHILDREN WILL NOT BE ABLE TO ATTEND WITHOUT PROPER CURRENT IMMUNIZATIONS. Must be dropped off by or at day one attendance.(jpg, jpeg, png, gif, pdf, doc, docx extensions max 2 megs size).

Medical Conditions/Allergies:

Additional Information we should be aware of:

I acknowledge that I have read and agree with all of the rules of the program and that the information provided above is accurate. I acknowledge that enrolling my child in the program you are assuming risks of medical expenses for my child that may be incurred due to any accidents.