462 SW Port Saint Lucie BLVD, Port Saint Lucie FL 34953 Email: Info@KidSpaceRocks.com wwW.KidSpaceRocks.com

Phone: 772-340-2140 

2026 / 2027 Camp Day Registration 

Can't make a day you paid for? It carries over to the second semester — usable on any Kid Space camp day January through May 2027.

Parents/Guardians Contact Information

Allergies/Medical Conditions:

Release For Pick Up

Please name 3 people in addition to Guardians listed on the first page, who may sign out your child from our center without prior written permission. These individuals will be allowed to remove your child from our care without contact from you, after showing a valid driver's license. (Id will be required)

No Contact Order/ Custody Information

Please notify the Director in writing of any persons who are to have no contact with your child. Please include a copy of any No Contact Order per any court decision. This includes custody disputes. By signing below, you state that you have read and agree to the rules and conditions outlined in the Kid Space LLC Policies and Procedures.

MEDIA RELEASE

I understand that both still and video images may be taken of my child and may be used in advertising material or on Kid Space/ Sochin Martial arts/Wish Me Luck Farms websites, as well as posted to our Facebook or Instagram.

ASSUMPTION OF RISK, RELEASE, AND WAIVER OF LIABILITY

I understand that my child's participation in Kid Space Camp Days, including indoor and outdoor play, games, sports, crafts, and other supervised activities on the Kid Space premises, involves a risk of injury. On behalf of myself and my child, I knowingly and voluntarily assume all risks associated with my child's attendance and participation, including the risk of bodily injury, illness, or damage to property, whether arising from the activities themselves, from other participants, or from conditions on the premises.

In consideration of Kid Space permitting my child to attend, I, on behalf of myself, my child, and our heirs, executors, and assigns, release, waive, and discharge Kid Space LLC and its owners, employees, volunteers, and agents from any and all claims, demands, or causes of action of any kind arising out of or related to my child's attendance and participation, except to the extent caused by the gross negligence or willful misconduct of Kid Space. I further agree to indemnify and hold Kid Space LLC harmless from any claim brought by or on behalf of my child arising from my child's attendance.

I confirm that my child is in good health and able to participate in camp activities, and that I have disclosed all allergies, medical conditions, and dietary restrictions above. I authorize Kid Space staff to obtain emergency medical treatment for my child if I cannot be reached, and I accept financial responsibility for any such treatment.

I have read this Assumption of Risk, Release, and Waiver of Liability, I understand its terms, and I am signing it voluntarily. My signature below applies to this release, the Media Release, the Release for Pick Up, and the No Contact Order/Custody Information above.

Kid Space Camp Field Trip/Medical Release Form

As the parent/guardian of the child named above, I hereby grant consent for him/her to participate in Kid Space approved field trips while enrolled in Kid Space Camp Days, Spring Break Camp, or Summer Camp from September 1st, 2026 - August 31st, 2027. I have been advised in writing or by verbal notification of all trips available to my child over the course of the season, including destinations, dates and travel arrangements.

It is my understanding that Kid Space will advise me by written or verbal notification of any changes to the posted schedule in sufficient time to enable me to communicate any withdrawal of consent for the specific trip or activity. Trip changes will be posted in the front lobby.

I understand that Kid Space LLC and its subsidiaries will be held harmless from any damages or claims that might arise from injuries out of any act or omission on the part of Kid Space as a result of such a trip or activity.

I understand that travel arrangements for my child include walking to locations within reasonable distances, such as other businesses in our plaza. When walking students will remain on sidewalks and off main roads. When driven my child will be in a Kid Space approved vehicle and driven by an approved driver. Although Kid Space vans will be the primary transportation, approved chaperoning parents will be allowed to transport my child as well with prior verbal notification.

As the parent/guardian of the above named student, I hereby give authorization to the staff of Kid Space LLC to transport my child to the nearest emergency room if for any reason they require minor medical treatment. I understand that emergency medical personnel may be called to transport at the discretion of the director. I further authorize the hospital and its medical staff to administer treatment as deemed necessary for the well-being of said student. I understand that the staff will make every attempt to notify me in all medical emergencies, and I will be contacted if possible for my permission if hospitalization or treatment of a serious nature is required. I have read and understand the above and freely give my consent and permission of all things contained.

I have read and understand the Kid~Space contract. I agree that my credit card may be charged in the event I do not make payments as specified in this contract. I understand that my card may be charged weekly for any outstanding fees owed on my account, including tuition, late fees, returned check fees, or unpaid lunch fees.