To register for a camp session, please complete this form and return it to the Snyder Fitness Center. Please use a separate form for each child. Please print. This form may be photocopied. If the preferred camp session is full, your child will be placed on a waiting list.
*Upon completion of this registration form. Please provide a list of your children’s allergies and a 5 X 7 photo of your child for our attendance roster.
Child’s Name (first, middle, last)
¨ Male ¨ Female
Date of Birth Age
Address
City State Zip Code
Parent/Guardian Phone (w) Phone (c)
Phone (evening) E-mail
T-Shirt Size (circle one) Child: S M L Adult: S M L XL
Summer Camp Rates: Residents Fee (Early Bird Rate-by May 2nd) Non-Residents Fee (Early Bird Rate-by May 2nd)
Full Day Sessions (8:30-4:30pm M-F) - $250.00 Full Day Sessions (8:30-4:30pm M-F) - $275.00
½ Day Sessions (8:30-Noon M-F) - $175.00 ½ Day Sessions (8:30-Noon M-F) - $192.50
Before Care (7-8:30am M-F) - $50 Before Care (7-8:30am M-F) - $55
After Care (4:30-6pm M-F) - $50 After Care (4:30-6pm M-F) - $55
Both Before and After Care- $90 Both Before and After Care- $100
-2nd Child Discount: 10% off for 2nd or 3rd child when registering at same time as 1st child.
-NO REFUNDS
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Session |
Camp Name |
Dates |
Choose Desired Sessions: (please circle) |
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1 |
Kingstowne Summer Camp |
June 23rd – 27th |
Full Day |
½ Day |
before care |
After care |
Both before & After |
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2 |
Kingstowne Summer Camp |
July 7th - 11th |
Full Day |
½ Day |
before care |
After care |
Both before & After |
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3 |
Kingstowne Summer Camp |
July 14th - 18th |
Full Day |
½ Day |
before care |
After care |
Both before & After |
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4 |
Kingstowne Summer Camp |
July 21st – 25th |
Full Day |
½ Day |
before care |
After care |
Both before & After |
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Total Number of Sessions (4 weeks or 1 week) |
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total amount for all sessions ($) |
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Sub Total ($) |
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Subtract Discounts |
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Grand Total |
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$ Payment: Payable by check or credit card. *Make check/money order payable to:
WTS International/Kingstowne
If paying by Credit Card: Card Number: Exp. Date: _____/_____
Card Holder’s Name (as appears on card): Signature:
The information on this page is correct so far as I know, and the person herein described has my permission to participate in all camp activities. If he/she appears ill, I will not send him/her to the camp program. I understand there are NO REFUNDS for this program.
Parent/Guardian Signature Date
I understand that participation in field trips is voluntary. I also understand that participation in field trips may include, and require participation in recreational activities, and that participation in these activities will expose my child to some risk of injury or even death.
I give permission to the WTS INTERNATIONAL/KINGSTOWNE Summer Camp program to take my child on Field Trips away from the normal camp site during his/her stay at the camp. I understand that my child will be appropriately chaperoned and supervised by the WTS INTERNATIONAL/KINGSTOWNE Summer Camp staff. I understand that if transportation is required, my child will be transported in an approved vehicle that may or may not be owned and operated by the WTS INTERNATIONAL/KINGSTOWNE, and that my child may be transported to age appropriate activities at a property or facility that may or may not be owned by WTS INTERNATIONAL/KINGSTOWNE. I also understand that all emergency action procedures and policies in place when my child is on WTS INTERNATIONAL/KINGSTOWNE Summer Camp property will be enforced off of WTS INTERNATIONAL/KINGSTOWNE Summer Camp property.
Parent/Guardian Signature Date
I, , the parent/guardian of , request that the WTS INTERNATIONAL/KINGSTOWNE Summer Camp staff apply sunscreen to my child during camp hours.
The WTS INTERNATIONAL/KINGSTOWNE Summer Camp participants spend a great deal of time in the outdoors and are thereby exposed to the sun’s harmful rays. Parents/guardians will be responsible for applying the first layer of sunscreen prior to morning drop off. The camp staff will apply follow-up applications after one hour in the water, after two hours of activity in the sun (due to perspiration), and/or any other time as needed. Parents or legal guardians will be responsible for providing their children with enough sunscreen (in a sealed container) to take with them for later day applications. One container per child. Please be sure to write your child's name on his or her sunscreen. Please note, this will mean your child will have the sunscreen applied for them by the day camp staff, and while we will make every effort to keep your child safe, we will not be help responsible for any sunburn incurred while at camp. Please explain this to your child before camp.
Parent/Guardian Signature Date
Please read this form carefully and be aware that in registering your minor child for participation in the above program/programs, you will be waiving and releasing all claims for injuries your child might sustain arising out of the above program/programs, including transportation services when provided.
I recognize and acknowledge that there are certain risks of physical injury to participants in the above program(s) and I agree to assume the full risk of any such injuries, damages or loss regardless of severity which my child may sustain as a result of participating in any activities connected or associated with any such program(s). I waive and relinquish all claims my child may have against the WTS INTERNATIONAL/KINGSTOWNE Summer Camp and its officers, agents, servants and employees as a result of participating in any of the above program(s). I hereby fully release and discharge the WTS INTERNATIONAL/KINGSTOWNE Summer Camp and its officers, agents, servants and employees from any and all claims from injuries, damage or loss which my child may have or which may accrue to my child on account of the participation of my child in any of the above program(s). I further agree to indemnity and hold harmless and defend the WTS INTERNATIONAL/KINGSTOWNE Summer Camp and its officers, agents servants and employees from any and all claims resulting from injuries, damages and losses sustained by my child, and arising out, connected with, or in any way associated with the activities of any of the program(s). I have read and fully understand the above program details and waiver and release of all claims.
Parent/Guardian Signature Date