Clone of PAS Registration Form

Invoice Number

We are delighted to announce that KiddieCorp will be hosting the children's program during WPC 2026. 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 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.

CHILDREN'S PROGRAM DETAILS

Date and Hours:

Sunday, May 24: 9:00 a.m. to 5:00 p.m.

Monday, May 25: 9:00 a.m. to 5:00 p.m.

Tuesday, May 26: 9:00 a.m. to 5:00 p.m.

Wednesday, May 27: 9:00 a.m. to 5:00 p.m.

Location:

Phoenix Convention Center in Phoenix, Arizona

Ages:

6 months through 12 years old

Ratios:

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 (No partial hours offered)

or

$80.00 per day, per child with a free lunch

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

Light, child-appropriate snacks and water will be available in the room for children. Parents are responsible for meals.

Parents may purchase a boxed lunch for $15.00 per child, drop off a meal at check-in, or sign their child(ren) out to take them to lunch.

Each full-day registration includes one complimentary boxed lunch per child.

KiddieCorp's program is nut-free. We kindly request that you refrain from bringing any snacks or meals containing nuts or nut products.

ACTIVITIES
The activities include exciting themes, arts & crafts, group games, music & movement, board games, story time, dramatic play, etc. They 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 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

YesNo

Please be as detailed as possible.

YesNo

Please list the special needs and specify which child is impacted if you have multiple children.

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

$10.00 per hour, per child (no partial hours offered)

or

$80.00 per day, per child with a free lunch

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.

Sunday, May 24: 9:00 a.m. to 5:00 p.m.

:HourMinutesAM/PM Option

Until

until :HourMinutesAM/PM Option

Total Hours Used

Monday, May 25: 9:00 a.m. to 5:00 p.m.

:HourMinutesAM/PM Option

Until

until :HourMinutesAM/PM Option

Total Hours Used

Tuesday, May 26: 9:00 a.m. to 5:00 p.m.

:HourMinutesAM/PM Option

Until

until :HourMinutesAM/PM Option

Total Hours Used

Wednesday, May 27: 9:00 a.m. to 5:00 p.m.

Wednesday, May 27: 9:00 a.m. to 5:00 p.m..

:HourMinutesAM/PM Option

Until

until :HourMinutesAM/PM Option

Total Hours Used

Daily Total

Additional Information

Boxed lunches are available for $15.00 each. Please select the day(s) you would like to purchase lunch for your child(ren). If your child(ren) are registered for full-day programming, lunch is already included and no additional selection is required.

Sunday, May 24Monday, May 25Tuesday, May 26Wednesday, May 27

# of Children

Total Hourly Fees

Hourly Rate

Total Full Days

Meals Total

Final Total (Hidden)

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

Cancellations must be made to KiddieCorp prior to May 4, 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.

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 Name:*

Emergency Contact Phone Number*

Area CodePhone Number

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, World Parkinson Coalition, 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 World Parkinson Coalition 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*

WPC Children's Program

Parent Information

Child(ren)'s Information

Program Fee

Dates & Times

Meals

Payment

Cancellation Policy

Authorized Pick-Up

Emergency Contact

Liability Release