Emergency contacts: in case of emergency and neither parent can be contacted, the following
people have my permission to pick up my child from school, or to meet my
child at hospital:
_______________________________________ Phone: home: ____________ work: ___________
Relationship to my child: ________________________________________________
KMS has my permission to transport my child to an emergency treatment centre in the event that
it is necessary. I will be called to meet my child and staff member at the hospital:
Signed: __________________________________________
Allergies and reactions :________________________________________________
Applying for (please check all that are requested):
| ___ | Week 1 . (July 5-9) .................................................... | "Little Artists" | ......... $110 |
| ___ | Week 2 . (July 12-16) ............................................... | "Children Around the World" | ......... $100 |
| ___ | Week 3 . (July 19-23) ............................................... | "Kids in the Kitchen" | ......... $110 |
| ___ | Week 4 . (July 26-30) ............................................... | "Devoted to Dinosaurs | ......... $100 |
| ___ | Week 5 . (August 3-6) .............................................. | "Wet and Wild" (4-day week) | ......... $ 80 | ___ | Week 6 . (Aug 9-13) .................................................. | "Mighty Machines" | ......... $100 | ___ | Week 7 . (Aug 16-20) ................................................ | "Science and Nature" | ......... $100 |
| ___ | Week 8 . (Aug 23-27) ................................................ | "Music and Theatre" | ......... $100 |
All children are accepted on the basis that their behaviour will not be detrimental to
the group. If behaviour becomes intolerable or violent, the parent will be asked to
remove the child from the KMS Summer Fun Program. No refund of fees will be given.
Signature of parent or guardian: _____________________________ Date: _______________