June 23 through July 11*
9 AM to noon
*Closed for the Fourth of July holiday, July 4
(1st and 2nd grade classes are full)
Rose Tree Elementary School
Registration for summer recreation is now open. Children
entering kindergarten through fifth grade are eligible to participate in
the program and will be grouped according to age. Activities
include arts and crafts, drama, sports, story time, and special event
days. Please complete the required registration form below and
return it to the municipal building. Registration forms may be
dropped off or mailed to 935 North Providence Road, Media, PA 19063.
The fee for the three-week program is $75. Please make checks
payable to Upper Providence Township.
We ask that you drop off/pick up your child near the
kindergarten/first grade entrance. Teachers and counselors will be
outside to meet/dismiss your children.
If you have any questions, please contact 610-565-4944.
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Child’s name: ______________________________ Phone#____________________
Address: ____________________________________________________________
Date of Birth: _______________________ Grade entering September
2008: ________
Health information/Allergies/medical conditions:
___________________________________________________________________
___________________________________________________________________
Emergency contacts:
Name: _______________________________ Phone # ______________________
Address: ___________________________________________________________
Name: _______________________________ Phone # ______________________
Address: ___________________________________________________________
Doctor’ Name: _________________________ Phone # ______________________
Address: ___________________________________________________________
Signature of parent/guardian: ____________________________________________
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