* = Required Information

Kingdom Care Camps 2019 Enrollment Form (3)

Please make additional copies for each camper

Parental Consent - Parents must agree to all items and this signed form must be submitted to Kingdom Care before your camper can be enrolled in any camp. Please initial beside each statement as indicated by line. Thank you.

I hereby give permission for my camper to participate in Kingdom Care Camps conducted by Kingdom Care, including fieldtrips whether by metro, bus or van.

I hereby give permission for emergency medical attention to be administered to my camper by the camp staff, in the form offirst aid and/or C.P.R.

When I cannot be contacted, I hereby authorize Kingdom Care to have my camper transported to a hospital emergency room,and the hospital and medical staff have my authorization to provide any treatment, at my expense, that a physician deemsnecessary for the wellbeing of my camper.

I hereby release Kingdom Care, its counselors and volunteers from any liability resulting from any loss, injury orillness to my camper and/or his/her property while attending Kingdom Care Camps. I understand that every effort will bemade to provide reasonable and safe care by the camp.

By applying to Kingdom Care Camps, I accept the following terms and conditions:

Admissions: Camp spaces are filled on a first come, first served basis. Kingdom Care reserves the right to close registrationfor camp weeks that are full or to cancel camps that are under enrolled. Canceled weeks will entitle families to a full refund forthat week.
Behavior: Any camper whose behavior endangers him/her or others will be removed from the camp without refund.
Respect: Campers will be expected to speak respectfully to adults and follow given directions. Campers who do not shall bewritten up for lack of respect. If a camper is written up 3 times in a given week, the camper will be dismissed, without refund.
Belongings: Your camper’s name should be written clearly on all clothing and belongings. Please do not send valuable items(such as jewelry or cash) to camp with your camper.

**READ CAREFULLY**__Late Pick Up: Camp closes at 5:30pm. There is a 5 minute grace period for pick up. At 5:36 p.m. a late fee of $25 and $2 per minute afterward per family, will be due when you pick up your camper (ren). If needed, please make arrangements for alternate pick up to avoid the late fee.

Photos:I hereby give Kingdom Care Camps permission to use photographs of my camper for promotional purposes.Photographs used for the web site or print ads will be changed, upon request.

Changes/Deposit/Refunds:

Deposits are nonrefundable, tuition is non refundable and activity fees are non refundable.
Please select weeks carefully; the fee to switch to another week is $50.

Parent may elect another week if a camper can’t attend a week registered for, space permitting.

I have read all of the above items understand them and give my consent. All statements above areto be initialed in agreement.


******Families only pay for the weeks their camper is present****** Page 4 of enrollment

Enrollment is available on a first come, first served basis. The tuition for camp is $180 per week, this is tuition only, andactivities are paid in advance in the form of a deposit. (see deposit below). Activities are $30 weekly. Camp hours 7:00 am- 5:30 p.m. Monday-Friday. To enroll.

*1. Place an X beside each week for enrollment below; please include your child’s name too.

*2. Submit enrollment form and include any questions in the message box with the form.

*3. Pay the non- refundable deposit for activities. The deposit is payable in 4, 3, 2 or 1 payment (s) but the deposits are dueby 6/1/19. Registration is not final until each week has a deposit paid. Tuition is due for each week, the Sunday before theweek starts.


Kingdom Care within 24 hours once the enrollment form is submitted" id="" >Pay in person in cash at Kingdom Care within 24 hours once the enrollment form is submitted
Pay the deposit via Cash App or Venmo
Pay the deposit via credit card (3.5% + .15 cent transaction fee) - an invoice will be sent in no more than 24 hours from Square

2019 Sessions and Dates

Session 1- June 17-21 Session 2-June 24-28
Session 3 –July 1-5 Session 4-July 8-12
Session 5-July 15-19 Session 6-July 22-26
Session 7-July 29- August 2 Session 8-August 5-9
Session 9-August 12-16 Session 10-August 19-22

*August 23- Camp will be closed

Session 11-August 27-31-CLOSED

An additional fee for Camp T-shirts will be ordered May 11. An email will be sent for orders for shirts. (Camp shirts are $40 for 3, no less than three can be ordered). Shirts size, please place an X near one:

4 6-8 10-12 12-14
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