KidsCamp portfolio, 2013 - KidsCare of Pennsbury

“Special Activity Options” Registration Form
“Special Activity Options” are an optional KidsCamp program activity and require separate registration. All KidsCamp
“Special Activity Options”, weeks, and costs are listed below. If you wish your child to participate in any or all of the “Special
Activity Options” please complete and return this registration with your KidsCamp registration.
Directions:
1. Please print and complete all required information.
KidsCamp
2. Use one form per child. If necessary, copy form to register additional children.
3. Available “Special Activity Options” spaces are strictly limited, and will be filled on a first come, first served basis.
4. A non-refundable “full” payment in the amount of the total “Special Activity Option” fees due must accompany the original KidsCamp
registration form. No partial payments will be accepted.
5. All “Special Activity Option” fees are non-refundable, regardless of reason.
2013
... a unique summertime experience for kids!
6. KidsCamp reserves the right to cancel any “Special Activity Option” activity with insufficient enrollment. In such a case, the “Special Activity
Option” fee will be credited to the participant’s KidsCamp account and/or refunded at the end of the child’s KidsCamp enrollment.
7. Participation in a “Special Activity Option” may pose inherent risks. Registration of a child into a “Special Activity Option” signifies that the
parent and/or guardian acknowledge and understand there are inherent risks associated with many “Special Activity Option” activities,
and will assume the risk associated therewith, whether known or unknown at the time of registration.
KidsCamp “Special Activity Options”
Child’s Name ______________________________________________________
Circle the appropriate “Special Activity Option(s)”, circle week(s) of participation, and calculate total fee due to indicate your
KidsCamp “Special Activity Options” preference(s) for the above indicated child.
IMPORTANT NOTE: Participation in KidsCamp for the week that the child wishes to participate in a “Special Activity Option” is required.
The fee for the “Special Activity Option” is an extra charge that must be paid in addition to the weekly KidsCamp tuition fee.
“Special Activity Option” Weeks Available Fee: TOTAL FEE
(Circle Choices)
(# of weeks x Fee)
Lacrosse -- 2 -- -- -- 6 -- -- $75 (per week) ______________
(Week 2: M, T, TH, F; Week 6: M, T, W, F)
A World of Illusions: A Magic Workshop -- -- -- 4 -- -- 7 -- $75 (per week) ______________
(Week 4: Tuesday & Thursday; Week 7: Tuesday & Friday)
KidsDance -- -- 3 -- 5 -- -- -- $75 (per week) ______________
(Monday, Tuesday, Thursday, & Friday)
KidzArt -- 2 -- -- -- 6 -- -- $75 (per week) ______________
(Tuesday, Thursday, & Friday)
Ceramics For Kids -- -- 3 -- 5 -- -- -- $65 (per week) ______________
(Tuesday & Thursday)
Rock Climbing -- -- -- 4 -- -- 7 -- $95 (per week) ______________
(Thursday & Friday)
Guitar -- 2 3 4 5 6 7 -- $50 (per week) ______________
(Monday)
________
Total “Special Activity Options” Fees Due
(enter this fee on line “E” on the reverse side of the Program Registration Form as part of the required registration deposit/initial payment)
_______________________________________________
Signature of Parent/Guardian
__________________
Date
Mail to: KidsCamp, 1456 Ferry Road, Suite 700, Doylestown, PA 18901
Fax to: 215-230-3344
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