Triad Summer Kid Care Registration Form 2008

                                                        Child’s Name:_________________________________ Age:____________

                                                         Address:______________________________________________________

                                                         Home Phone:__________________ Alternate Phone:__________________

                                                         Parent(s) Name:________________________ School:_________________

                                                         Email Address:________________________________________________

Summer Kid Care

Please circle the dates and times that your child will attend and whether or not you will need AM or PM extended child care.  Refer to the Day Camp Fee Schedule in the Summer Camp Brochure.  Additionally, a parent signature is required on a liability waiver on or before the first day of camp.

Return this form to the Triad front desk along with payment or call to register over the phone with a credit card.   There will be a $5 processing fee for changes made after initial registration.