CDA Registration Form

Invoice Number
CDA Children's Program
We are delighted to announce that KiddieCorp will be hosting the children's program during the 2026 CDA Spring Scientific Sessions. With forty 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's longstanding partnership with the American Academy of Pediatrics has played a key role in establishing us as a premier provider of children's program services. Our commitment to caring for your children is our top priority, ensuring they not only have fun but also receive excellent care.

CDA CHILDREN'S PROGRAM DETAILS

Date and Hours:

Thursday, May 14 - 6:45 a.m. to 6:00 p.m.

Friday, May 15 - 6:45 a.m. to 6:00 p.m.

Saturday, May 16 - 6:45 a.m. to 4:30 p.m.

Location:

Hilton Anaheim Hotel in Anaheim, California

Ages:

6 months through 12 years old

Ratios for children:

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:

Full Day Rates:

$50.00 for children ages 6 months to 6 years old

$40.00 for children ages 7 years to 12 years old

Half Day Rate:

$30.00 for children ages 6 months to 6 years old

$25.00 for children ages 7 years through 12 years old

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 and snacks will be provided. Parents are responsible for supplying meals each day. You may either drop off a meal at the program or sign your child out to take them to lunch. Alternatively, meals can be purchased from the hotel upon check-in.

KiddieCorp's program is nut-free. We kindly request that you refrain from bringing any snacks or meals containing nuts or nut products.
CDA KidZone
CDA KIDZONE DETAILS
Date and Hours:
Thursday, May 14 - 9:30 a.m. to 6:00 p.m.
Friday, May 15 - 9:30 a.m. to 6:00 p.m.
Saturday, May 16 - 9:30 a.m. to 4:30 p.m.

Location:
Anaheim Convention Center in Anaheim, California

Ages:
4 through 12 years old

Cost:
$5.00 for up to three hours per child

Pre-registration for KidZone is not available. All registrations for KidZone are conducted onsite. It operates on a first-come, first-served basis.
Program Information and Terms & Conditions
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.
- KiddieCorp staff will not perform diapering procedures on children above the age of five years old.
- 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 other health limitations, allergies, or special needs?*

YesNo
Does your child(ren) have any special needs under the Americans with Disabilities Act?*

YesNo
Please be as detailed as possible.
Child(ren)'s Information
Number of children you are registering*
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
Program Fee
Full Day Rates:

$50.00 per child, for children ages 6 months to 6 years old

$40.00 per child, for children ages 7 years old to 12 years old

Half Day Rate:

$30.00 per child, for children ages 6 months to 6 years old
$25.00 per child, for children ages 7 years old to 12 years old

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
Child One
Thursday. May 14th - FULL DAY
Thursday. May 14th - HALF DAY
Half Day Range*
Half Day Range*
Friday. May 15th - FULL DAY
Friday. May 15th - HALF DAY
Half Day Range*
Half Day Range*
Saturday. May 16th - FULL DAY
Saturday. May 16th - HALF DAY
Half Day Range*
Half Day Range*
Child One Total Fees
USD
Child Two
Thursday. May 14th - FULL DAY
Thursday. May 14th - HALF DAY
Half Day Range*
Half Day Range*
Friday. May 15th - FULL DAY
Friday. May 15th - HALF DAY
Half Day Range*
Half Day Range*
Saturday. May 16th - FULL DAY
Saturday. May 16th - HALF DAY
Half Day Range*
Half Day Range*
Child Two Total Fees
USD
Child Three
Thursday. May 14th - FULL DAY
Thursday. May 14th - HALF DAY
Half Day Range*
Half Day Range*
Friday. May 15th - FULL DAY
Friday. May 15th - HALF DAY
Half Day Range*
Half Day Range*
Saturday. May 16th - FULL DAY
Saturday. May 16th - HALF DAY
Half Day Range*
Half Day Range*
Child Three Total Fees
USD
Child Four
Thursday. May 14th - FULL DAY
Thursday. May 14th - HALF DAY
Half Day Range*
Half Day Range*
Friday. May 15th - FULL DAY
Friday. May 15th - HALF DAY
Half Day Range*
Half Day Range*
Saturday. May 16th - FULL DAY
Saturday. May 16th - HALF DAY
Half Day Range*
Half Day Range*
Child Four Total Fees
USD
Weekly Total
USD
Additional Information
Payment Information

Total*

USDDescription

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

Cancellation Policy
Cancellations must be made to KiddieCorp prior to April 23, 2026 for a full refund. Cancellations made after that date will be subject to a 50% cancellation fee. Once the program has begun, no refunds will be issued.
Authorized Pick Up
Please list only the individuals authorized to check out the above child(ren) from the KiddieCorp children's program, including parents/guardians:

(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, California Dental Association, 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 the California Dental Association 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 may disrupt the program or endanger the health and safety of others.
Signature*

Clear
Should be Empty:

CDA Children's Program

CDA KidZone

Program Information and Terms & Conditions

Parent Information

Child(ren)'s Information

Program Fee

Dates & Times

Child One

Child Two

Child Three

Child Four

Payment Information

Cancellation Policy

Authorized Pick Up

Emergency Contact

Liability Release