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Summer Program Enrollment Forms

The following forms must be completed prior to enrollment in our summer program

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(Click the links below to download and print each form. Hard copies of each form are also available for pick-up at the center)

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- Child Enrollment Form

- Emergency Care Consent Form

- General Off-site Permissions Form

- Transportation Plan Form

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If your child has allergies or any health conditions that require special attention or medication, please fill out these forms as well:

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- Individual Health Care Plan

- Medication Consent Form

our two locations in brookline, ma are:

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224 Washington St, brookline village 

&

44 WASHINGTON ST. suite A-106

The Brookhouse

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for more information please call us at: 

(857) 210-9122

© 2015 by The Golden Chickpea Center  

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