Registration

Registration

Already a customer? Click here to login.

Enjoy an evening for yourselves. Elk Grove Kids Camp will watch over and have fun with your kids. Drop off is 5:00pm. Pick Up is no later than 9pm. We will play outdoor and indoor games, do a fun project, make breakfast for dinner and wind down with a movie starting at 8:00pm. Cost is $35 per child. Sibling discount $5 off.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Alternate Emergency Contact(s) Name & Phone (will contact primary contacts first with an emergency)*

Students entered below will be added to your family's account

Add New Student #1:

(Show-Hide Details)

	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):*
	Medications (Leave blank if NONE):*
	Person Authorized for Pick Up:
	Persons Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:

Add New Student #2:

(Show-Hide Details)

	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)

	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):*
	Medications (Leave blank if NONE):*
	Person Authorized for Pick Up:
	Persons Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:

Add New Student #3:

(Show-Hide Details)

	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)

	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):*
	Medications (Leave blank if NONE):*
	Person Authorized for Pick Up:
	Persons Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:

Add New Student #4:

(Show-Hide Details)

	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)

	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):*
	Medications (Leave blank if NONE):*
	Person Authorized for Pick Up:
	Persons Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:

Add New Student #5:

(Show-Hide Details)

	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)

	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):*
	Medications (Leave blank if NONE):*
	Person Authorized for Pick Up:
	Persons Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:
	Person Authorized for Pick Up:

Additional Information:

Age of Participants

(Show-Hide Details)

Children must be between 5 and 12 years/11 months old.

I've read the above and agree.

Fully Independent in the Restroom

(Show-Hide Details)

Children must be fully independent using the restroom facilities.

I've read the above and agree.

Children showing signs of illness

(Show-Hide Details)

If your child is showing signs of illness; lethargy, fever, persistent coughing/ sneezing family will be required to pick them up immediately from the activity.

I've read the above and agree.

No Refunds

(Show-Hide Details)

Once Elk Grove Kids Camp has processed your payment you may not cancel your reservation and receive a credit or refund for this event.

I've read the above and agree.

Payments

(Show-Hide Details)

Payments can take up to 24 hours to process. Payment in full is required at the time of reservation. If payment is declined your child will be immediately dropped from the event.

I've read the above and agree.

Discounts

(Show-Hide Details)

Event fees for sibling discounts will be adjusted before your card is charged.

I've read the above and agree.

Activities

(Show-Hide Details)

Elk Grove Kids Camp has planned a variety of activities for the children while they are in our care. Some will be outside in our play yard and others will be inside; including an art project. Please dress your children appropriately.

I've read the above and agree.

Food

(Show-Hide Details)

Elk Grove Kids Camp will provide dinner for the children. We have decided to make pancakes with a variety of fruit. Bottled water will be served. If your child has dietary restrictions, where they are unable to eat the food made, please feed them in advance.

I've read the above and agree.

Movie

(Show-Hide Details)

Elk Grove Kids Camp will turn on a movie at 8:00 as a wind down activity for the kids. The movie will be Monsters Inc. If children do not want to watch the movie, they will be able to do a quiet activity at the tables.

I've read the above and agree.

Late Pick Up

(Show-Hide Details)

Please be punctual and considerate. Parents are to pick up their children no later than 9:00pm. A late fee of $3.00 per minute, per family, will be charged to your card if you are past 9:00pm for pick up. There is no grace period.

I've read the above and agree.

Release of Liability

(Show-Hide Details)

I hereby assume all of the risks of participating in Elk Grove Kids Camp, LLC and Sunshine Swim and Fitness Center, LLC., programs. Including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault. I certify that I am physically fit and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in Elk Grove Kids Camp, LLC and/or Sunshine Swim and Fitness Center, LLC., programs. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of the Elk Grove Kids Camp, LLC and Sunshine Swim and Fitness Center, LLC., in which I may participate and that it will govern my actions and responsibilities at said Sunshine Swim and Fitness Center facility. In consideration of my application and permitting me to participate in Elk Grove Kids Camp and Sunshine Swim and Fitness Center, LLC., programs, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A)I WAIVE, RELEASE, AND DISCHARGE Elk Grove Kids Camp, LLC and Sunshine Swim and Fitness Center LLC., managers, employees, contractors, volunteers and their property management company and its employees, contractors from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from Sunshine Swim and Fitness Center facility. (B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in Elk Grove Kids Camp and/or Sunshine Swim and Fitness Center programs, whether caused by negligence or otherwise. I acknowledge that participating in Elk Grove Kids Camp and Sunshine Swim and Fitness Center programs may carry with it the potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, employees, and lack of hydration. I consent and agree that Elk Grove Kids Camp, LLC and Sunshine Swim and Fitness Center, LLC., and/or their employees , representatives may take photographs or digital recordings of me as a participant during class and or special events and use these in any and all media for training or promotional purposes. I further consent that my identity may be revealed therein or by description text or commentary. I waive any rights, claims or interest and I understand that there will be no financial or other remuneration. The accident waiver, release of liability and image release shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. This contract will remain in effect for undersigned participant until a time in which Elk Grove Kids Camp, LLC, Sunshine Swim and Fitness Center, LLC or participant revokes or individualizes contract. At which time a revision will be drawn up and signed by all parties. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT. I SIGN IT ON MY OWN FREE WILL FOR MYSELF AND THE UNDER AGED PARTICIPANTS LISTED ON THE REGISTRATION FORM THAT I REPRESENT.

I've read the above and agree.

Enter your Full Name:

*

Other Questions/Comments:

Please fill out ONE of the following Payment Methods.

Credit Card Verification:

Card Number:

Name as it appears on card:

Nickname:

Card Expiration Month:

Exp Year:

Address Line 1:

Address Line 2:

City:

State: Zip:

eCheck/Bank Draft:

Additional Info

Bank Name:

Bank Routing Number:

(9-digit number)

Your Account Name:

(Your name on your bank statement)

Your Account Type:

Account Number:

Please Wait...