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Upper Providence Township Summer Recreation Program

  Dates: July 11 - August 5, 2016

Time: 8:30 AM to 11:30 AM, Monday through Friday

                                  Location: Rose Tree Elementary School

Registration 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.  Fee for the four-week program is $130. 
Please make checks payable to Upper Providence Township.

       We ask that you drop off your child at the kindergarten wing.  Campers should come daily with bottled water and sunscreen applied.

       If you have any questions, please contact 610-565-4944.



Child’s name: ______________________________ Phone#____________________

Address: ____________________________________________________________

Date of Birth: _______________________ Grade entering September 2016: ________

Health information/Allergies/Medical Conditions/Special Needs:


Emergency contacts:

Name: ______________ Phone # _____________ relation to child: ________________


Name: ______________ Phone # _____________ relation to child: ________________


Doctor’ Name: _________________________ Phone # _____________


Signature of parent/guardian: _____________________________________





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