Wicked Cool For Kids Summer Information Form

Student Information Form

This form serves as registration information for Wicked Cool For Kids programs.
Program week:
Program location
Child's Name

First NameLast Name
Child's Age as of June 2026
Parent/Guardian Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number 1
Please enter a valid phone number.Format: (000) 000-0000.
Phone Number 2
Please enter a valid phone number.Format: (000) 000-0000.
Notes or other information you'd like us to know about your child (habits, routines or other):
Emergency Contact Name & Phone Number:
My child has permission to walk home.
Allergies or other medical conditions that you'd like our instructor to know about:
Wicked Cool For Kids Policies

Behavior Policy

In order for children to get the most out of Wicked Cool For Kids programs, they need to feel comfortable and supported during class time. We expect children to be able to listen to our instructors, follow directions, and be courteous and respectful. We are happy to hear from you about what works for your child in advance so we can have a successful week.

The safety of all students in our programs is our number one priority. As such, any physical aggression will result in a child being immediately asked to leave the class and parents will be notified for pick up. For any disruptive behaviors, we will employ a three-chance system and will inform parents/guardians of each incident. If a child’s behavior does not improve after these three warnings, he or she may be removed from the class. As such, refunds will not be given for removal due to behavioral issues.

Pick up

Please respect our staff and be prepared to pick your child up on time. If your child is picked up late more than twice in one week, we reserve the right to withdraw the child without a refund. Children who have your permission to walk home must bring in a note from home or fill in the walk home form below.

Medication Policy

No over the counter medicine will be given to your child at a Wicked Cool For Kids summer program. If your child requires prescription medicine, it must be presented in original packaging with physician's orders and sealed in a plastic bag.
Acknowledgement

By hitting submit and your signature, you agree that you are the parent or legal guardian of the above-named child, and are over the age of 18.
- I understand that my child will be expected to abide by all rules and regulations which now exist or which may be hereafter adopted or amended by Wicked Cool For Kids for the safety and enjoyment of all participants.
- I acknowledge that my child is voluntarily participating in a Wicked Cool For Kids program and release Wicked Cool For Kids from liability or personal injury to my child during his or her participation in the program.
- I authorize Wicked Cool For Kids to seek medical treatment for my child in case of an emergency.
- Occasionally, photos and videos are taken and used as part of summer projects, rocket launches or for marketing purposes either by the hosting location or by Wicked Cool For Kids. No photographs will be identified by name or town, or fill in the opt-out form below.
- Wicked Cool For Kids reserves the right to dismiss any student for inappropriate behavior without refund.
- My child's registration will not be considered final until I complete the payment below.
Signature*

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Wicked Cool For Kids

5 Cherry Hill Drive

Suite 125

Danvers, MA 01923

www.wickedcoolforkids.com

781-281-2180
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Student Information Form