Summer Camp Detailed Registration Form

WE ARE SO EXCITED FOR KIDZ COURSE CAMP 2024!

We have so many fun things planned this year- including water play and getting some vitamin D! You won't regret sending your child! Its a great value for 5 hours of care!

PLEASE COMPLETE ONE REGISTRATION PER CHILD!

We know the cost of camp can be expensive for families. We offer a 20% sibling discount for the second and third child. Please pay full price for your first child and feel free to use the PROMO CODE "SIBLING20" for a 20% discount on your additional children.

Child's Name

First NameLast Name

Birth Date

MonthDayYear

Grade (as of September 2024)

Gender

MaleFemale

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name

First NameLast Name

Home Number

Cell Number

E-mail

example@example.com

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Alt. Phone Number

Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Kidz Course during the selected camp. In exchange for the acceptance of said child’s candidacy by Kidz Course, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Kidz Course 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 sessions.

In case of injury to said child, I hereby waive all claims against Kidz Course including all coaches 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 sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

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.

Date

My Products

AUG 26-30- INTERNATIONAL WEEKPLEASE SELECT WHICH DAY OF THE WEEK YOU WANT-TUESDAY SOLD OUT, WEDNESDAY SOLD OUT, Thursday-5 Spots Left, Friday- 7 Spots Left

$60.00 No. Of DaysMondayThursdayFriday

AUG 26-30-ADD ON PIZZA LUNCHPLEASE SELECT WHICH DAY OF THE WEEK YOU WANT

$10.00 No. Of DaysThursdayFriday

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card

Signature

Summer Camp Registration

Child's Information

Credit Card