Fun For Kids! Registration Form

Fun For Kids!

149 Lighthouse Rd.

Hilton Head, SC 29926

(843) 671-3590

Fax: (843) 363-2058

Parents Name: ________________ Vacation Dates: ______________

Local Address:____________________________________________

Home Phone: _________________ Cell Phone: __________________

Child’s Name(s): Ages: (Ages 4-12)

1. _____________________ _______

2. _____________________ _______

3. _____________________ _______

4. _____________________ _______

5. _____________________ _______

Daily Rates Per Child

• Morning Session: 9am-12pm @ $44.00 X ____ = _____
• Afternoon Session: 1pm-4pm @ $29.00 X ____ = _____
• Full Day Session: 9am-4pm @ $54.00 X ____ = _____
• Kids Nite Out (Thurs) 6pm-9pm @ $39.00 X ____ = _____

Refunds only given when reservations are cancelled 24 hours in advance!

Credit Card # ____________________ Expiration Date ____________

I, the undersigned parent/guardian, hereby consent to my child’s enrollment in the Sea Pines Fun For Kids! Summer Day Camp. I am aware that my child will be traveling by van/bus/boat to various locations. I hereby hold Sea Pines Resort, Fun For Kids!, and the Connections Company harmless from any and all liability. I understand that this regristration form gives my child permission to attend field trips out of Sea Pines Resort. This statement shall serve as a release and an assumption of risk for my child. Below is space to list any medical/medication information that is relevant to my child’s health. I also understand that there is a $15 fee for every 15 minutes that a child is picked up late.

*** Please list any allergies: __________________________________

Parent Signature: __________________________________

Dates
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