Daily PA/PD (Half Day)


  • MM slash DD slash YYYY
  • Parent/Guardian Information
  • Emergency Contact
  • Authorized to pick up (other than names parent/guardian above)
  • Relationship to camper (if more then 1 camper is registered on this form)
  • 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, its employees or agents (including NanK Educators Inc. operating as Young Engineers Greater Mississauga), to seek medical aid that may be required as a result of an accident or injury sustained by my child.
  • LIABILITY WAIVER - I, the undersigned, have read, understood, completed and signed the Kidsapia/Young Engineers Greater Mississauga liability waiver form and thereby agree that Kidsapia, its employees or agents (including NanK Educators Inc.) shall not be liable for any accident or injury sustained by my child or for any loss or damage to personal property arising from or in any way resulting from participation in Kidsapia & Young Engineers Greater Mississauga Camp programs.
  • MM slash DD slash YYYY
  • PHOTO PERMISSION and RELEASE (optional) - I give Kidsapia and NanK Educators Inc. permission to photograph my child and/or take video footage. These photographs and/or videos may be used by Kidsapia or NanK Educators Inc. for marketing and promotional material in Kidsapia and Young Engineers Greater Mississauga publications, advertisements, customer loyalty material and/or website and social media. Names will not be identified with any photo/video images.
  • MM slash DD slash YYYY
  • Please choose options below, and indicate whether you also want extended care before and/or after normal hours. Extended care is $6 per hour, or $15 for before and after care per day. Additional charge after 6 pm care is $20 per hour. To be paid on the day of camp.

    At bottom, please add any extra notes.

  • Friday, February 7, 2020

  • Monday, June 8, 2020

  • Friday, June 26, 2020