Name: Daily (Full Day)
SKU: 4655
Price: 55.00 CAD
Availability: InStock

Child's Name*

Date of Birth*

Parent/Guardian Information

Full Name*

Phone

Email*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Emergency Contact

Full Name

Phone

Authorized to pick up (other than names parent/guardian above)

Full Name

Relationship to camper (if more then 1 camper is registered on this form)

1.

2.

Child's Allergies

Child's Special Needs/Medical Conditions

Child's OHIP Number

The OHIP number will be required by healthcare providers in case emergency treatment is needed.

PERMISSION FOR KIDSAPIA TO SEEK MEDICAL ATTENTION - I, the undersigned, hereby authorise Kidsapia Inc, its employees, agents or affiliates (including NanK Educators Inc.), to seek medical aid that may be required as a result of an accident or injury sustained by my child/ren.

LIABILITY WAIVER - I, the undersigned, have read, understood, completed and signed the Kidsapia Inc. liability waiver form and thereby agree that Kidsapia Inc., its employees, agents or affiliates (including NanK Educators Inc.) shall not be liable for any accident or injury sustained by my child/ren or for any loss or damage to personal property arising from Inc. or in any way resulting from participation in Kidsapia Inc. Camp programs.

Parent/Guardian Name*

Date

PHOTO PERMISSION and RELEASE (optional) - I give Kidsapia Inc. and its affiliates (including NanK Educators Inc.) permission to photograph my child and/or take video footage. These photographs and/or videos may be used by Kidsapia Inc. or NanK Educators Inc. for marketing and promotional material in Kidsapia Inc. or Young Engineers Greater Mississauga publications, advertisements, customer loyalty material and/or on our website and social media. Names will not be identified with any photo/video images.

Parent/Guardian Name

Date

Please choose options below, and indicate whether you also want extended care before and/or after normal hours. Extended care is $8 per hour, or $18 for AM and PM per day, or $75 for the entire week (AM and PM). To be paid on the day of camp. Additional charge after 6 pm is $20 per hour (min $10)

At bottom, please add any extra notes.

Week 1 - July 2 to July 5, 2019 (4 days) Young Engineers (YE)-STEAM Camp

Purchase Option

Daily (full day)

Days

Tuesday, July 2
Wed, July 3
Thurs, July 4
Friday, July 5

Extended Care (Days)

Tuesday, July 2
Wed, July 3
Thurs, July 4
Friday, July 5

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 2 - July 8 to 12 (5 days) - Young Engineers (YE)-STEAM Camp

Purchase Option

Daily (full day)

Days

Extended Care (Days)

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 3 - July 15 to 19 (5 days) - Young Engineers (YE)-STEAM Camp

Purchase Options

Daily (full day)

Days

Extended Care (Days)*

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 4 - July 22 to 26 (5 days) - Young Engineers (YE)-STEAM Camp

Purchase Options

Daily (full day)

Days

Extended Care (Days)

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 5 - July 29 to August 2 (5 days) - Performance Arts

Purchase Options

Daily (full day)

Days

Extended Care (Days)

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 6 - Aug 6 to 9 (4 days) - Artistic Adventures

Purchase Options

Daily (full day)

Days

Tuesday, Aug 6
Wed, Aug 7
Thurs, Aug 8
Friday, Aug 9

Extended Care (Days)

Tuesday, Aug 6
Wed, Aug 7
Thurs, Aug 8
Friday, Aug 9

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 7 - Aug 12 to 15 (5 days) - Performance Arts

Purchase Options

Daily (full day)

Days

Extended Care (Days)

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 8 - Aug 19 to 23 (5 days) - Artistic Adventures

Purchase Options

Daily (full day)

Days

Extended Care (Days)

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

Week 9 - Aug 26 to 30 (5 days) - Performance Arts

Purchase Options

Daily (full day)

Days

Extended Care (Days)

Extended Care (Times)

8-9 am
4-5 pm
4-6 pm

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