Camper Application

 

Camper Last Name:
First Name:
Gender Male Female
Birthdate:
Grade:
Address:
Town:
Zip Code:
Telephone #:
Mother's Name:
Business #:
Cell# :
Father's Name:
Business #:
Cell# :
Emergency Contact:
Home #:
Cell # :
Email :
Doctor/Telephone # :
COMPLETE  
Gender: Male Female
Grade (SEPT 2013.) :
Age JULY 2013:
Camper's Last Name:
First Name:
Lunch:
Bring :
Town:
Cell #:
FS:
Session:
Session 1:
Session 2:
Other Dates (Which Weeks):
Mini Day (9-2):
First Time Kenwal Camper: Yes No
May we give your name for parties / Play Dates: Yes No
Allergies/Parent Comments :
Camper Grouping Request (2 only) Not Guaranteed, List in order Preference, Must have First & Last Name : 1.

2.
Other Dates (Which Weeks):
Mini Day (9-2):
TRANSPORTATION INFORMATION:
Camper Last Name:
First Name:
FS:
Session:
Session 1:
Session 2:
Address:
Other Dates (Which Weeks):
Town:
Zip Code:
Cell #:
Mini Day (9-2):
Name of closest Intersecting:
STANDARD CONDITIONS OF ENROLLMENT
Deposit must accompany each application. Balance to be paid by May 1st. All deposits refundable until April 1st. Refunds will be mailed April 15th. Tuition fee includes transportation, snack, arts & crafts materials, full accident insurance. ABSOLUTELY NO REFUND OF TUITION FOR MISSED DAYS, WITHDRAWAL OR CANCELLATIONS AFTER APRIL 1st. There will be no makeup days for days missed. It is understood that all photography taken at Kenwal Day Camp may be used for promotional purposes. Parent agrees that the child may be taken to places of recreation and interest without notice or further consent.
FS:
Session:
Session 1:
Session 2:
Address:
Other Dates (Which Weeks):
Tuition :
Lunch :
Bring :
Total :
Deposit :
Balance Due: