Ky's Kidz Summer Camp Registration Form
  • Summer Camp Registration

    Ky’s Kidz Summer Day Camp strives to provide high quality, diverse, educational and recreational activities that will enhance the quality of life for all of our campers. Camp hours of operation are as follows: Before-care (7:30am-9am) Breakfast (8:30am-9:30am) Camp Hours (9am-4pm) Aftercare (4pm-6pm) $250 NON-REFUNDABLE DEPOSIT is required to secure enrollment. (Sibling Discounts are available, please email us at kyimah@kyskidz.com for multiple child enrollment.)
  • Camper Information

  • Gender*
  • Parent/Guardian Information
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Emergency Information
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Alternate Pickup Designation

    *Please indicate 1-2 people you authorize Ky's Kidz staff to discharge your camper to.

  • Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Ky's Kidz LLC during the 2022 camp season. In exchange for the enrollment of child by  Ky's Kidz LLC., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Ky's Kidz LLC and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp activities. In case of injury to said child, I hereby waive all claims against Ky's Kidz . including all Ky's Kidz staff and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all high risk activities, including swimming, basketball, football, etc. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

  • Medical Release and Authorization As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

    Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible.

    This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to Ky's Kidz LLC and its affiliates including Camp/Asst. Camp Directors, Health Director and Counselors to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season.

    This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

    I acknowledge that Ky's Kidz does NOT administer medication, however, medication can be held and dispensed for self administration by camper with staff supervision if appropriate medical dispensation authorizations forms are submitted prior to the first day of camp.

  • Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

  • Tuition Payment Guidelines & Pay-Plans

    For parents/guardians that select a deposit option, there are three pay plans available: 3-pay, 5-pay and 8-pay. 

    3-pay plan:
    1st Payment: $725 (due by 6/3)
    2nd Payment: $725 (due 7/1)
    3rd Payment: $725 (due by 7/29)

    5-pay plan:
    1st Payment: $450 (due by 6/3)
    2nd Payment: $450 (due 6/17)
    3rd Payment: $450 (due by 7/1)
    4th Payment: $450 (due by 7/15)
    5th Payment: $450 (due by 7/29)

    8-pay plan:
    1st Payment: $300 (due by 6/10)
    2nd Payment: $300 (due 6/17)
    3rd Payment: $300 (due by 6/24)
    4th Payment: $300 (due by 7/1)
    5th Payment: $300 (due by 7/8)
    6th Payment: $300 (due by 7/15)
    7th Payment: $300 (due by 7/22)
    8th Payment: $300 (due by 7/29)

    *Regardless of pay-plan, camper tuition must be paid up through their July 1st installments no later than 7/8/22 for camper to start on the 1st day of camp.

    If final payment is not received by 7/29/22 camper registration will be suspended and camper will not be able to return to camp until balance is paid in full.

    **Refund requests submitted prior to June 10, 2022 will be processed with $550 non-refundable deposit deducted.

    After 6/11/2022, NO REFUNDS will be processed for any reason, including but not limited to withdrawal, suspension, expulsion, etc. 

    No Exceptions!

  • Camp Tuition Costs: 6 Week Camp Season July 11-August 19, 2022 (Mon-Fri, 9am-4pm)

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            Full Tuition

            Tuition Includes: $250 NON-REFUNDABLE DEPOSIT, 6-week camp enrollment ($395/weekly), 2 meals daily, 2 snacks daily, admission to ALL field trips (10 total trips-(3)for ages 5-8, (3) for ages 9-12 and 4 trips for all campers. All trip meals included (with exception of lunch at Liberty Science Center, Crayola Experience & Dorney Park).Campers will also receive (1) camp t-shirt (to be worn on field trips) and a camper swag bag.

            $2,375.00$2,375.00
              
            Ages 5-8 Camp Registration

            Campers must submit a NON-REFUNDABLE $250 deposit to secure camper registration. Tuition Includes: 6-week camp enrollment, 2 meals daily, 2 snacks daily, admission to ALL field trips (10 total trips-(3)for ages 5-8, (3) for ages 9-12 and 4 trips for all campers. All trip meals included (with exception of lunch at Liberty Science Center, Crayola Experience & Dorney Park). Campers will also receive (1) camp t-shirt (to be worn on field trips) and a camper swag bag.

            $250.00$250.00
              
            Ages 9-12 Camp Registration

            Campers must submit a NON-REFUNDABLE $250 deposit to secure camper registration. Tuition Includes: 6-week camp enrollment, 2 meals daily, 2 snacks daily, admission to ALL field trips (10 total trips-(3) for ages 5-8, (3) for ages 9-12 and 4 trips for all campers. All trip meals included (with exception of lunch at Liberty Science Center, Crayola Experience & Dorney Park). Campers will also receive (1) camp t-shirt (to be worn on field trips) and a camper swag bag.

            $250.00$250.00
              
            Before-care/Aftercare Pre-Payment Bundle

            When added during registration, camper will be enrolled in both before and aftercare services for the entire camp season (6 weeks).

            $450.00$450.00
              
            Total
            $0.00$0.00
          • Payment Methods

            Choose from one of the PayPal options to make your payment.

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