General InformationCamper's Name First Last Gender Male Female Age (as of July 1, 2025) Birthdate MM slash DD slash YYYY School Name Grade camper will be entering after summer of 2025 ends First time Kenwal Camper? Yes No Camper comments: ( allergies, extra needs that will help us to provide the tools necessary for your child and their group to succeed in a fun and safe environment) IF NONE, PLEASE WRITE NA * RequiredAddress Street Address Address Line 2 City ZIP Code May we give your name for parties/play dates? Yes No Parent 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 2025 Dates, Programs & ExtrasCheck each and every week your child will attend Select All Week 1 6/30-7/3 Camp closed July 4th Week 2 -7/7-7/11 Week 3 -7/14-7/18 Week 4 -7/21-725 Week 5 -7/28-8/1 Week 6 -8/4-8/8 Week 7 -8/11-8/15 Week 8 -8/18-8/22 If less than 5, check days camper will attend: Monday Tuesday Wednesday Thursday Friday Mini Day Extreme Teen Overnight Travel Attending 4 Weeks "Extreme Teen" & Combining with Teen Program 8 Weeks EXTREME TEENS ONLY 1st 4 Weeks EXTREME TEENS ONLY Last 4 Weeks EXTREME TEENS ONLY Lunch is included in tuition Shirt Size Youth - XS Youth - S Youth - M Youth - L Adult - S Adult - M Adult - L Adult - XL Adult - XXL Transportation InformationTransportation Options * Required I will provide transportation for my child Kenwal will provide transportation at an additional cost of $ 125.00 per week Address for Pick Up Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent 1 Cell PhoneParent 2 Cell PhoneName of Closest Intersecting Street Camper may enter home alone: Yes No Nursery Campers Under 4 Years of Age Will Need a Car Seat: Yes - Car Seat Required No - Car Seat Not Required N/A Conditions of Enrollment * Required I agree to the Conditions of EnrollmentSTANDARD CONDITIONS OF ENROLLMENT: Deposit must accompany each application. A second payment of $800 is due February 1st. Balance to be paid by May 1st. All deposits fully refundable until March 1st 2024. 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 DUE TO WEATHER, WITHDRAWAL OR CANCELLATION AFTER MARCH 1ST. There will be no makeup days for absences. Transportation cost assumes buses operate at design capacity. 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. The camp reserves the right to dismiss any camper whose behavior represents a danger to the camp or campers. 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 * Required Email Camper grouping request: Request (2 Only) Not Guaranteed, list in order of preference. We must have first and last name. I WAS REFERRED BY ( ONLY ONE PERSON ALLOWED) PhoneThis 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 2024 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
