Regestartion 8 to 12

Note: Filling out this form requires payment when submitting. Payments are secured by Pay-Pal. If you wish to pay by mail, see information at the bottom of this form. Thank You!

Child's Name*

Parents Name*

Address*

Child D.O.B*

Grade Attending *

Work Phone*

Mobile Phone*

E-mail*

T Shirt Size*

S ( 6- 8 )
M ( 10-12 )
L ( 14-16 )
Adult SM
Adult Med
Adult L
Adult XL

Days attending (Min.of 3 days)*

M
T
W
TH
F

Check the weeks your child will be attending and check lunch for the weeks you want to use the lunch program. (please note ! That you are charged for these weeks whether or not your child attends ) *

Field Trip Agreement:*

I Agree (By checking this Box you Parent / Guardian give permission for your child to participate in all activities and attend all bus field trips and / or walking field trips on the days your child attends summer camp at King's Kids Academy.

Once you click the submit button you will be transferred to Pay-Pal for payment. Please note you will be paying for one child and must submit one form for each child.

Paypal

Camp Adventure Quest Registration- ages 8 to 12