Summer Camp Detailed Registration Form

KCA Summer Camp Registration Form
Dates: June 1st - August 7th, 2026

Time: 7:30AM - 1PM

Location: 4701 Valley Pike. Stephens City, VA 22655

For more info: Ask our AI assistant on our website www.kidtimechristianacademy.com/summer-camp

Please call or email if you have additional questions:

540-944-3555 | info@kidtimechristianacademy.com
Camper Information
Camper's Name*

First NameLast Name
Age*
MaleFemale
June 1st - 5thJune 8th - 12thJune 15th - 19thJune 22nd - 26thJune 29th - July 3rdJuly 6th - 10thJuly 13th - 17thJuly 20th - 24thJuly 27th - 31stAugust 3rd - 7th
YesNo
Camper's Name*

First NameLast Name
Age*
MaleFemale
June 1st - 5thJune 8th - 12thJune 15th - 19thJune 22nd - 26thJune 29th - July 3rdJuly 6th - 10thJuly 13th - 17thJuly 20th - 24thJuly 27th - 31stAugust 3rd - 7th
3 Days per Week ($135/week)5 Days per Week ($225/week)
Parent/Guardian Information
Name*

First NameLast Name
Relationship*
Mobile Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Confirmation

By signing below, I acknowledge and agree to the following: A $50 non-refundable deposit is required at the time of enrollment to secure my child’s spot in Kidtime Christian Academy Summer Camp. I understand that campers must enroll for a minimum of four (4) weeks during the summer program. I acknowledge that tuition is billed weekly and must be paid in full prior to attendance each week. I understand that tuition is non-refundable and not prorated for absences due to illness, vacations, or other scheduling conflicts. I further acknowledge that submission of this registration form does not guarantee placement and that enrollment is only confirmed once the required deposit has been received.
Date

MonthDayYear
Date
Signature*
Should be Empty:

KCA Summer Camp Registration Form

Dates: June 1st - August 7th, 2026

Camper Information