Summer in the K.A.V.E. 2021 Application

Galway Campus

Thank you for your interest in learning more about us. Please fill out the following form and we will get back to you as soon as possible. Please don’t hesitate to contact us if you have any questions, comments, or concerns. A member of our faculty will be happy to assist you with your needs.

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To apply:

Print and complete the Summer in the K.A.V.E. 2021 Application and return it with the non-refundable $200 deposit by personal check, Paypal (, Venmo ( Academy Child Development Center) or money order payable to Academy. Please mail to Academy Child Development Center, ATTN: Amber Impton, 10109 Darnestown Rd., Rockville, MD 20850. Registration is also available online via our website
Please be sure to provide an email address, and sign & date the bottom of this application.
Child's Name*
MM slash DD slash YYYY
Child’s Home Address:*
Parent/Guardian Name:

Terms & Contractual Agreement

As a parent or legal guardian, I am requesting enrollment for my school-age child for the indicated sessions. I agree to abide by the terms as outlined below:

Completed applications will be considered on a first-come basis and must include application, tuition worksheet, non-refundable deposit towards your weekly session. Incomplete applications will not be accepted and will be returned.

  • Academy’s Summer in the K.A.V.E. Program is for children entering Kindergarten through 5th grade.
  • Tuition includes In-house Field trips, materials, as well as one afternoon snack.
  • Academy’s programs will be closed Monday, July 5, 2021.
  • Academy will send you a summer enrollment contract for your child via email.
  • Group size is limited and space is offered on a first come, first served basis.
  • If my child is dropped off before or picked up after their registered hours, I understand that Academy will charge late fees set forth in the Late Pick-Up Policy of our Academy Family Handbook.
  • I understand that all mandatory licensing paperwork, medications and written plan of action for my child must be completed and submitted at least one week before my child is scheduled to start the program.
  • Academy reserves the right to cancel any week(s) due to low/decreased enrollment.
  • Acceptance is based upon Academy’s ability to meet your family’s needs. Enrollment is on a trial basis. Academy reserves the right to terminate services for your child and/or family without a refund.
  • Children and parents are expected to work cooperatively with Academy staff and administrators.
  • I/We understand that I/We are responsible for all tuition payments and fees for my/our child in the Academy Summer in the K.A.V.E. 2021 Program.
  • I/We authorize my/our child and to participate in all activities and my/our understanding and acceptance of the inherent risks of participation in active recreational activities both indoors and outdoors.
MM slash DD slash YYYY
MM slash DD slash YYYY
Child’s Name:*

Weekly Session Rates:

Please place a checkmark next to the weekly session(s) you would like your child to attend.
Summer 2021 Weeks*
Select Weeks*

Non-Refundable Fees & Payment Information

  • $50 Non-Refundable Registration Fee per family.
  • $200 Non-Refundable Deposit due per child. *Non-Refundable deposit will be applied towards your child’s last weekly session.
  • All summer payments must be paid via ACH Direct Debit ,PayPal, or Venmo (see box at bottom for details).
  • Please review your Enrollment Contract carefully for dates of attendance, program hours and payment details to ensure accuracy.
  • All payments and fees are nonrefundable.
    Summer 2021 payment schedule is as follows:
    1. If attending weeks 1-2, payment is due with signed contract.
    2. If attending weeks 3-6, payment is due on 5/1/21.
    3. If attending weeks 7-10, payment is due on 6/1/21.
  • All applications received after June 16, 2021 will be required to pay the entire summer balance in full.

For subsidy information, please see the link below:

Summer 2021 Incentives:

  • $25 off each week when signing up for 2 weeks or more!
  • Refer a new friend (who has never attended Academy) for 2 sessions and receive a $75 credit towards your summer tuition (not redeemable for cash). *Redeemable Summer 2021 Only
Office Use Only:Non-Refundable Registration Fee (per family): $50 Ck#: ________ Date: ____________ Staff Initial: _________ *Non-Refundable Deposit Amount: $200 Ck#: _______ Date: __________ Total Tuition Due: $ _________________________ Eligible Credits or Discounts:_____ Subsidy Vouchers: Yes: ________ No __________
Monthly ACH Authorization (must complete a new form and attach a voided check).
PayPal Processing (includes a 2.5% processing fee per transaction). Invoices will be sent to your email and must be paid within 48 hours of when the email was sent.
Venmo: (pay directly to Academy Child Development Center through Venmo)

Comments: __________
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