KARE FAMILY CAMP REGISTRATION
Name of Family
*
Name of Oldest Child in KYL
*
KYL Member ID of oldest child in KYL
Please enter your 5 digit KYL Member ID if known. Leave blank if unknown.
Please select a camp date
*
Friday, May 26 - Sunday, May 28
Saturday, June 3 - Sunday, June 4
Saturday, June 10 - Sunday, June 11 is now full.
Type of Camp
2 Day
3 Day
Please enter your Immediate Family Members
These are people in your IMMEDIATE family (mom, dad, son, daughter, etc.) This does not include grandma, grandpa, uncles, aunts, cousins, friends, etc.
Contact Name - Parent 1
*
First Name
Last Name
Parent 2
First Name
Last Name
Contact Phone
*
-
Area Code
Phone Number
Contact Email
*
Confirmation Email
Please confirm your email in the second box
Home Address
*
Street Address
Street Address Line 2
City
Please Select
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Alaska
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California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
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Mississippi
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Nebraska
Nevada
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North Carolina
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Ohio
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Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
How Many Babies (Age 0-2)
0
1
2
3
4
No Charge for Babies
Baby 1
*
First Name
Last Name
Baby 2
*
First Name
Last Name
Baby 3
*
First Name
Last Name
Baby 4
*
First Name
Last Name
How many Children (Ages 3-12)
0
1
2
3
4
5
6
Child 1
*
First Name
Last Name
Age
*
3
4
5
6
7
8
9
10
11
12
Child 2
*
First Name
Last Name
Age
*
3
4
5
6
7
8
9
10
11
12
Child 3
*
First Name
Last Name
Age
*
3
4
5
6
7
8
9
10
11
12
Child 4
*
First Name
Last Name
Age
*
3
4
5
6
7
8
9
10
11
12
Child 5
*
First Name
Last Name
Age
*
3
4
5
6
7
8
9
10
11
12
Child 6
*
First Name
Last Name
Age
*
3
4
5
6
7
8
9
10
11
12
Adult Children (Ages 13 and over)
0
1
2
3
4
5
6
Adult Child 1
*
First Name
Last Name
Adult Child 2
*
First Name
Last Name
Adult Child 3
*
First Name
Last Name
Adult Child 4
*
First Name
Last Name
Adult Child 5
*
First Name
Last Name
Adult Child 6
*
First Name
Last Name
Extended Family Members
This includes grandparents, or other family members currently living in YOUR home. They must be in the SAME household. Other relatives living OUTSIDE your household need to fill out their own registration.
How many extended family members would like to attend
0
1
2
3
4
5
6
Extended Family Member1
*
First Name
Last Name
Relation
*
Grandma
Grandpa
Uncle
Aunt
Cousin
Other
Extended Family Member2
*
First Name
Last Name
Relation
*
Grandma
Grandpa
Uncle
Aunt
Cousin
Other
Extended Family Member3
*
First Name
Last Name
Relation
*
Grandma
Grandpa
Uncle
Aunt
Cousin
Other
Extended Family Member4
*
First Name
Last Name
Relation
*
Grandma
Grandpa
Uncle
Aunt
Cousin
Other
Extended Family Member5
*
First Name
Last Name
Relation
*
Grandma
Grandpa
Uncle
Aunt
Cousin
Other
Extended Family Member6
*
First Name
Last Name
Relation
*
Grandma
Grandpa
Uncle
Aunt
Cousin
Other
Additional Information
Does anyone in your family have food allergies or dietary restrictions? If yes, please explain:
Does anyone in your family have medical or physical restrictions/needs? If yes, please explain:
Is there any other information about your family that you would like us to know?
Pricing
Child Price
Age 3-12
Adult Price
Age > 12
> 5 Price
Ext Family Price
# Children
Age 3-12
# Adults
Age >12
# > 5
# Extended Family
Family Price
Total Cost
Item Key
Customer Key
Amount Due
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USD
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