AK Camp Registration Form

Appalachian Kayak Summer Day Camp Registration

Thank you for your interest! I am so excited for Kayak Camp! You may complete this form in the way that suits you best. 1. Complete the forms electronically online. 2. Print, complete, and scan both forms and email them to appalachiankayak@hotmail.com.

*Please don't forget to complete the Medical Authorization Form.

Payment due upon registration. If registering by March 31st, enter coupon code "Early" for the $10 Early Bird Discount. If registering siblings, enter coupon code "Sibling" for the $10 Sibling Discount.

Week 1:

If this is the week you are registering for, type an X, if not leave it blank.

Week 2:

If this is a week you are registering for, type an X, If not, leave it blank.

Week 3:

If this is a week you are registering for, type an X, if not, leave it blank.

Week 4:

If this is a week you are registering for, type an X, if not, leave it blank.

Week 5:

If this is a week you are registering for, type an X, if not, leave it blank.

First Child's Name*

What age will this child be at the time of camp?*

Second Child's Name

What age will this child be at the time of camp?

Third Child's Name

What age will this child be at the time of camp?

Parent 1*

Address*

Email*

example@example.com

Cell phone*

Parent 2

Address

Email

example@example.com

Cell phone

How did you learn about Appalachian Kayak Summer Camp?

If from an online search, please say which site. If a friend referred you, please include their name. Thank you!

1. Upon acceptance of your registration and payment, a place is reserved for your child in Appalachian Kayak Summer Camp. If for any reason the enrollment must be canceled, Appalachian Kayak must be advised in writing and will provide a refund of $220. All changes must be made at least three weeks prior to the start of the camp enrollment to be canceled.

2. No refunds are made for absences or withdrawals after camp has started. 3. A medical form is provided. This form must be on file prior to the first day of camp. 4. Registration is an acknowledgement that the parent/guardian grants permission for the child to participate in kayaking and related activities. The parent/guardian assumes all risks and hazards incidental to the conduct of activities and transportation to and from Appalachian Kayak and anyone connected with the program from any liability associated with the program. 5. Appalachian Kayak has permission to use photographs/videos of kayak camp for publicity purposes unless a written statement to the contrary is on file prior to the start of the camp. 6. Appalachian Kayak reserves the right to cancel any participant's enrollment or dismiss a participant whose mental condition, conduct, influence or behavior is deemed unsatisfactory to the best interests of the program, the child's own safety or the safety of others. No refund is made if a participant is expelled from kayak camp. I have read and agree to the terms above. Signature:

Signature*

Multiple payment methods are available. I can take credit card information over the phone, or you may use Venmo (@Stephanie-Hoover-64) or Apple Pay (text 717-315-5730). If you have any questions, please call or email me. Thanks! Stephanie

Stephanie Hoover

Appalachian Kayak, LLC

appalachiankayak@hotmail.com

appalachiankayak.com

(717) 805-8980

My Products

Five-day camp

$290.00 Quantity

Four-day Camp

$255.00 Quantity

One day camp

$65.00 Quantity
Item subtotal:$0.00

Transportation: One dayPick-up and drop off at Fort Hunter Park

$15.00

Transportation: All weekPick-up and drop off at Fort Hunter Park

$75.00

Late pick-up: Individual rate

$45.00

Late pick-up: Family rate

$65.00

Enter coupon

Total

$0.00

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