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Camper Information
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Kids In Action Summer Program Registration Form |
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Last Name
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First Name
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Hebrew Name
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Gender
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Date of Birth
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Grade
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Shirt Size
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Carpool / Transportation
Request
(additional fees may apply)
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Sessions
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Parent Information
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Father
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Title
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First Name
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Last Name
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Work Phone
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Cell Phone
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Email
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Mother
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Title
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First Name
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Last Name
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Work Phone
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Cell Phone
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Email
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Emergency Information
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Emergency 1
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Emergency 2
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I Will Fill Out And Send In The Medical Form Click Here For PDF Medical Form
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Payment Information
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Session 1 / $300 Tuition Fee / Per Week
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Session 2 / $200 Tuition Fee / Per Week
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One Day / $60 Tuition Fee / Per Day/ Qty
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Card Type
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Card Number
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Expiration Date
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Security Code
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Name on Card
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Billing Address
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Billing Postal Code
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Terms and Conditions
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TUITION FEES & REFUND POLICY: Tuition fees are $200/$300 per session or $500 for both sessions. All payments are non-transferable to other parties and not exchangeable for other weeks. Registration is per week, no prorating per day. The $25 registration fee is due upon registration and is non-refundable. The weekly tuition fees are due by July 15th and are fully refundable until July 20th. After July 20th, there will be no refunds granted.
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EMERGENCY CARE: I have filled out and will send in the medical form. In the event of an emergency, serious illness, or accident, KIA Mcallen has my permission to arrange for necessary first-aid or care by a licensed physician for my child(ren) while he/she is attending camp.
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IMAGES: KIA Mcallen is hereby granted permission to use any individual or group camp photos and or videos showing our child(ren) involved in camp activities.
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DAMAGES: As parents or guardians, we agree to be responsible for any loss, damage or destruction by our child to any property of KIA Mcallen or to any property for which the camp is liable or chargeable.
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SIGNATURE & AGREEMENT: I give my child(ren) permission to participate in all KIA Mcallen activities, including but not limited to swimming, water-front activities and group field trips, unless specified in written notice to the camp by me.
I here by agree to all the above including the registration fee required and my name typed in below acts as my signature in full agrrement
Full Name
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