General InformationCamper's Name First Last GenderMaleFemaleAge (as of July 1, 2021)Birthdate - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY School NameGrade camper will be entering after summer of 2021 endsFirst time Kenwal Camper?YesNoCamper Grouping Request: Request (2 Only) Not Guaranteed, list in order of preference. We must have first and last name.Address Street Address Address Line 2 City ZIP Code May we give your name for parties/play dates?YesNoParent 1 Name First Last Home PhoneParent 1 Business PhoneParent 1 Cell PhoneParent 1 Email Parent 1 Occupation (Optional)Parent 2 Name First Last Parent 2 Business PhoneParent 2 Cell PhoneParent 2 Email Parent 2 Occupation (Optional)Emergency Contact First Last Emergency Contact Business PhoneEmergency Contact Cell Phone 2021 Dates, Programs & ExtrasCheck each and every week your child will attend Select All Week 1 - 6/28-7/2 Week 2 - 7/6-7/9 No Camp Monday 7/5 Week 3 - 7/12-7/16 Week 4 - 7/19-7/23 Week 5 - 7/26-7/30 Week 6 - 8/2-8/6 Week 7 - 8/9-8/13 Week 8 - 8/16-8/20 If less than 5, check days camper will attend: Monday Tuesday Wednesday Thursday Friday Mini Day Extreme Teen 8 Weeks 1st 4 Weeks Last 4 Weeks Attending 4 Weeks "Extreme Teen" & Combining with Teen/CIT Program Lunch Hot Cold Vegetarian Bring Tuition and FeesTuitionTeen Extreme TuitionLunchTotalDepositBalanceShirt SizeYouth - XSYouth - SYouth - MYouth - LAdult - SAdult - MAdult - LAdult - XLAdult - XXL Transportation InformationTransportation Options * Required I will provide transportation for my child Kenwal will provide transportation at an additional cost of $ 120.00 per week Address for Pick Up Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent 1 Cell PhoneParent 2 Cell PhoneName of Closest Intersecting StreetCamper may enter home alone:YesNoNursery Campers Under 4 Years of Age Will Need a Car Seat:Yes - Car Seat RequiredNo - Car Seat Not RequiredN/AConditions of Enrollment * Required I agree to the Conditions of EnrollmentSTANDARD CONDITIONS OF ENROLLMENT: Deposit must accompany each application. Balance to be paid by May 1st. All deposits fully refundble until April 1st 2021. Refunds mailed on April 15th. Tuition fee includes: Snack, arts & crafts materials, sunscreen, towels and full accident insurance. NO REFUND OF TUITION FOR MISSED DAYS, WITHDRAWAL OR CANCELLATION AFTER APRIL 1ST. There will be no makeup days for absences. It is understood that digital imaging taken at/for Kenwal Day Camp may be used for promotional purposes. Parent agrees, their child may be taken to places of recreation / interest without further notice or consent. Parent agrees to abide by the provisions of the Kenwal Day Camp Parent Handbook. Terms and Conditions * Required I agree to the terms and conditions.I agree that any dispute concerning, relating, arising out of or referring to the subject matter of this contract shall be resolved exclusively by binding arbitration in Suffolk County, New York, according to the then existing commercial rules of the American Arbitration Association and the substantive laws of that state. The arbitrator and not any federal, state or local court or agency shall have exclusive authority to resolve any dispute relating to the interpretation, applicability, enforceability, conscionability, or formation of this contract, including but not limited to any claim that all or any part of this contract is void or violable. I have read the enrollment agreement and understand its terms and accept all conditionsParent Signature * RequiredEmail EmailThis field is for validation purposes and should be left unchanged. Come see us in actionBook a TourMake Your Appointment!Sign Up for a funfilled summer at Kenwal! Summer 2021 Dates and Rates are in effect. Sign up now for an amazing summer at Kenwal Day Camp! Register for Camp learn more about Kenwal Day CampHave Questions?Request Info!Come See Us in Action!Book a Tour
