Tiny Travelers Day Camp (Fall Break)

Tiny Travelers Day Camp Registration

Fall Break September 30-October 4, 2024 Tuition is $245 for the week which includes admission in to all excursions. This program is from 7:30 am - 5:30 pm.
Select the day you wish to enroll your child.*
Date (Based on availability)

MonthDayYear
Date
Child's Information
Child's Name*

First NameLast Name
Birth Date*

MonthDayYear
Traveler's Grade Level*
Gender*

MaleFemale
Parent/Guardian Information
Parent/Guardian #1*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*
Work Number
E-mail*
example@example.com
Parent/Guardian #2*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*
Work Number
E-mail*
example@example.com
Does the child have any allergies, chronic illness, or medical conditions?*

YesNo
If yes, please explain:
I give permission for Kidtopia to transport my child to and from any and all excursions and field trips planned for each day.*

Agree
I understand that Kidtopia Tiny Travelers Day Camp is an active program with physically challenging activities available for student participation.*

Agree
I knowingly and voluntarily assume all risks involved in my child's participation and do hereby release Kidtopia, and its members, trustees, officers, employees, independent contractors, and agents from any and all liability, damages, costs, and expenses arising out of or relating to bodily or psychological injury, loss of life or personal property that may occur as a result of participating in this program, regadless of cause.*

Agree
I understand that participating in field trip activities, facility play, climbing walls, indoor and outdoor play equipment, inflatable obstacles, slides, and all excursion plans entail certain risks. Those risk can include increased heart rate, blood pressure, strained or sprained muscles, fractured bones, partial or complete paralysis, heart attacks, psychological injury, death, or possibility of any other serious injury. I elect to allow my child to participate in any and all activities in spite of these risks.*

Agree
My child and/or I have read, understand and accept the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon the parties during the entire period of participation in the program.*

Agree
I understand that my child may be photographed and photos may be used in media publications that would represent Kidtopia and its program in a positive manner.*

Agree
I understand that a registration fee of $50 is due to ensure child's enrollment and is non-refundable. I understand that tuition of $245 is due the Monday prior to the week of camp, and if not received may result in my child being dismissed from the program.*

Agree
I understand that a two week written notice of un-enrollment is required for any reason for withdrawal. If a two week written notice is not received, I understand that the full amount of tuition will still be required and paid in full.*

Agree
I understand that bad language and behavior that is disruptive, disrespectful, and/or aggressive will not be tolerated and further agree that dismissal of my child is at the discretion of the Program Director.*

Agree
Kidtopia has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported.*
Type First and Last name above to consent
Sign Enrollment Agreement*

Clear
Date Signed*

MonthDayYear
Date
Should be Empty:

Tiny Travelers Day Camp Registration