KC Minicamp Registration
Mother's Name
*
First Name
Last Name
Father's Name
*
First Name
Last Name
Home Phone
*
-
Area Code
Phone Number
Mother's Cell
*
-
Area Code
Phone Number
Father's Cell
*
-
Area Code
Phone Number
Mother's E-mail
*
Father's E-mail
*
Camper Information
Child 1 Name
*
First Name
Last Name
Child 1 Birthday
*
-
Month
-
Day
Year
Date Picker Icon
Child 1 Age
*
Child 2 Name
First Name
Last Name
Child 2 Birthday
-
Month
-
Day
Year
Date Picker Icon
Child 2 Age
Child 3 Name
First Name
Last Name
Child 3 Birthday
-
Month
-
Day
Year
Date Picker Icon
Child 3 Age
Are you a KC KIDS Member?
*
Yes
No
Camp Days
Erev Rosh Hashana (9/20) - Register by 9/7
Full Day
Half Day
Erev Yom Kippur (9/29) - Register by 9/7
Full Day
Half Day
Sukkot - Register by 9/25
Erev Sukkot (10/4)
Full Day
Half Day
Chol Hamoed Sukkot I (10/9)
Full Day
Half Day
Chol Hamoed Sukkot II (10/10)
Full Day
Half Day
Chol Hamoed Sukkot III (10/11)
Full Day
Half Day
Chanukah Break (12/18) - Register by 12/8
Full Day
Half Day
Yeshiva Week - Register by 1/5
Day 1 (1/22)
Full Day
Half Day
Day 2 (1/23)
Full Day
Half Day
Day 3 (1/24)
Full Day
Half Day
Day 4 (1/25)
Full Day
Half Day
Day 5 (1/26)
Full Day
Half Day
Camp Days
Erev Rosh Hashana (9/20) - Register by 9/7
Full Day
Half Day
Erev Yom Kippur (9/29) - Register by 9/7
Full Day
Half Day
Sukkot - Register by 9/25
Erev Sukkot (10/4)
Full Day
Half Day
Chol Hamoed Sukkot I (10/9)
Full Day
Half Day
Chol Hamoed Sukkot II (10/10)
Full Day
Half Day
Chol Hamoed Sukkot III (10/11)
Full Day
Half Day
Chanukah Break (12/18) - Register by 12/8
Full Day
Half Day
Yeshiva Week - Register by 1/5
Day 1 (1/22)
Full Day
Half Day
Day 2 (1/23)
Full Day
Half Day
Day 3 (1/24)
Full Day
Half Day
Day 4 (1/25)
Full Day
Half Day
Day 5 (1/26)
Full Day
Half Day
Subtotal
All Camp Discount
How many children are you registering?
1
2
3
Grand Total (including 10% discount for registrants 2 and 3)
Please enter any additional information pertinent to the camper(s). E.g. allergies, etc.
Submit
Clear Form
Should be Empty: