Kids Club 2022

Kids Club 2022 Registration Form

Child's Last Name

Child's First Name

Age

Allergies

* Parent's First Name

* Parent's Last Name

* Parent's Email

* Parent's Cell Phone

Home Phone

Address

City

Zip Code

Kids Club tuition is $250/child.

YesNoI am interested in sponsoring the ice cream truck for $200

Photo/Video Release - I acknowledge that Kids Club is responsible for producing and publishing a variety of newsletters, brochures, videos and fliers. I hereby authorize Kids Club/JCAB to use, reproduce or publish photographs or videos of my child which may be taken during our participation in Kids Club activities for any purposes without compensation to me or my child.

I-agree-to-the-photo/video-releaseI-do-not-agree-to-the-photo/video-release

* Total Camp Fees

Tue, May 30 2023 10 Sivan 5783

100 Nassau Ave, Atlantic Beach, NY 11509

Kids Club 2022

Kids Club 2022 Registration Form