AGU Registration Form

Invoice Number
Camp AGU
We are delighted to announce that KiddieCorp will be hosting Camp AGU during the Annual Meeting. With thirty-eight years of experience, KiddieCorp has been a trusted provider of high-quality children's programs and youth services for conventions, trade shows, and special events.

KiddieCorp has solidified its position as a leading provider of children’s program services through its endorsement and longstanding partnership with the American Academy of Pediatrics. Our top priority is the care of your children, ensuring they not only enjoy themselves but also receive exceptional care.

CAMP AGU DETAILS

Date and Hours:

Monday, December 9th - 8:00 a.m. to 6:30 p.m.

Tuesday, December 10th - 8:00 a.m. to 6:30 p.m.

Wednesday, December 11th - 8:00 a.m. to 6:30 p.m.

Thursday, December 12th - 8:00 a.m. to 6:30 p.m.

Friday, December 13th - 8:00 a.m. to 6:30 p.m.

Location:

Walter E. Washington Convention Center in Washignton, DC

Ages:

3 months through 12 years old

Ratios:

1:1 for children ages 3 motnhs through 5 months old

1:2 for children ages 6 months through 11 months old

1:3 for children ages 1 through 2 years old

1:5 for children ages 3 through 5 years old

1:7 for children ages 6 through 12 years old

Cost:

$10.00 per hour, per child. Children must be registered a minimum of two consecutive hours per child for each day they are registered.

We encourage early registration as availability is limited and operates on a first-come, first-served basis. To secure advance reservations, both the registration form and full payment must be received by KiddieCorp. On-site registration will be limited to available space.

MEALS/SNACKS

Water will be provided for all children. Parents are responsible for snacks and meals. You also have the option to sign your child out to take them to lunch or drop off a meal at camp.

Camp AGU is nut-free. We kindly request that you refrain from bringing any snacks or meals containing nuts or nut products.

ACTIVITIES
Activities include exciting themes, arts & crafts, group games, music & movement, board games, story time, dramatic play, etc. We tailor activities to suit each age group appropriately.

TEAM MEMBERS

Our goal is to provide your children with a comfortable, safe, and happy experience. KiddieCorp team members are selected according to their integrity, experience, education, and enthusiasm. Every program has a CPR/First aid certified manager that is on site at all time.

REGISTRATION TERMS AND CONDITIONS

Additional information for parents:
- KiddieCorp staff does not administer medication, including sunscreen.
- For the safety and enjoyment of all, children who are ill will not be admitted to the program.
- Please label your child's belongings. While we maintain a lost and found, KiddieCorp does not assume responsibility for lost or stolen items.
- Parents with infants, kindly bring diaper changing supplies, formula/baby food, and a change of clothes for your child's comfort.
NEED MORE INFORMATION?

KiddieCorp is available to answer any questions. Feel free to contact KiddieCorp by phone at (858) 455-1718 or by e-mail at info@kiddiecorp.com.
Parent Information
Parent Name*

First NameLast Name
Parent Name

First NameLast Name
E-mail Address*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Does your child(ren) have any health limitations or allergies.*

YesNo
Please be as detailed as possible.
Does your child(ren)have special needs that we should be aware? (E.g. as defined under the Americans Disabilities Act)*

YesNo
Please list the special needs and specify which child is impacted if you have multiple children.
Child(ren)'s Information
How many children would you like to register:*
Child 1 First Name*
Child 1 Last Name*
Age at time of program*
Child 2 First Name
Child 2 Last Name
Age at time of program
Child 3 First Name
Child 3 Last Name
Age at time of program
Child 4 First Name
Child 4 Last Name
Age at time of program
Camp AGU Fee
The fee is $10.00 per hour, per child. Children must be registered a minimum of two consecutive hours per child for each they are registered.

KiddieCorp accepts MasterCard, Visa, American Express, & Discover.

Payment in full is required to confirm your reservation. Please make sure to bring a photo ID with you to the children's program. A photo ID will be required for check-in and check-out of children.
Dates & Times

Please add drop off and pick up times for each day your child(ren) is attending Camp AGU.
Monday, December 9th - 8:00 a.m. to 6:30 p.m.

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Total Hours Used
Tuesday, December 10th - 8:00 a.m. to 6:30 p.m.

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Total Hours Used
Wednesday, December 11th - 8:00 a.m. to 6:30 p.m.

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Total Hours Used
Thursday, December 12th - 8:00 a.m. to 6:30 p.m.

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Total Hours Used
Friday, December 13th - 8:00 a.m. to 6:30 p.m.

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Total Hours Used
Weekly Total
Additional Information
Cancellation Policy
Cancellations must be submitted to KiddieCorp by November 25, 2024 to receive a full refund. No refunds will be issued after this date.
Payment Information
# of Children
Cost Per Hour
Total Fee(Hidden)

Total Fee*

USD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Authorized Pick Up
Please list only those allowed to check-out the above child(ren) from the KiddieCorp children's program:

(Please list name and relationship; photo ID will be required when checking out children):
How many people are authorized to check-out the above child(ren)?*
Contact 1 Information*

Name:Relationship:
Phone Number

Area CodePhone Number
Contact 2 Information

Name:Relationship:
Phone Number

Area CodePhone Number
Contact 3 Information

Name:Relationship:
Phone Number

Area CodePhone Number
Contact 4 Information

Name:Relationship:
Phone Number

Area CodePhone Number
Emergency Contact

Someone who is not with you onsite
Emergency Contact Name:*
Emergency Contact Phone Number*

Area CodePhone Number
Liability Release
We, the undersigned adults, agree to place our child or ward in the KiddieCorp children’s program. For ourselves, our child/ward (or children/wards), and each of our respective heirs, assigns, and next of kin, we hereby release and agree to indemnify and hold harmless KiddieCorp, AGU, and their respective officers, directors, agents, employees, assigns, vendors, and the owners and/or lessors of the facility or facilities where the program will be held (collectively “the Releasees”), from any and all claims which may now or hereafter arise from our child’s/ward’s (or children’s/ward’s) participation in the KiddieCorp program. We do not release claims arising from Releasees for any of their willful misconduct or gross negligence.

Photographs taken throughout the children’s program may be used for promotion and/or publication by AGU and KiddieCorp, Inc.

We have read the above and understand this release. Furthermore, in the event of an emergency or health concern, KiddieCorp has our permission to administer first aid, contact our pediatrician, or obtain emergency medical treatment for our child. We agree to pay all expenses incurred due to an emergency involving our child.
KiddieCorp reserves the right to limit participation of any child whose presence or behavior mat disrupt the program or endanger the health and safety of others.
Signature*

Clear
Should be Empty:

Camp AGU

Parent Information

Child(ren)'s Information

Camp AGU Fee

Dates & Times

Cancellation Policy

Payment Information

Authorized Pick Up

Emergency Contact

Liability Release