Kids Connection Summer Registration Logo
  • Kids Connection Summer Registration

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  • Parent/Guardian Information


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  • Emergency Contact Information

  • Please list three emergency contacts (other than parent/guardian) that we may contact in the event of an emergency. These people will also act as authorized adults to pick up you child. 

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  • Medical Information

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  • Transportation Agreement

  • I am the parent or guardian of the undersigned child. I hereby authorize Plainfield United Methodist Church and/or Kids Connection (the “Organization”) to transport my child to and from any of the Organization’s activities (the “Transportation”) and I hereby release and waive any claims against the Organization, its organizers, directors, officers and volunteers arising from the Transportation. To the extent any claims are asserted against the Organization relating to the Transportation, I agree to indemnify and hold the Organization harmless from and against any and all liabilities, losses, damages, expenses and claims of any kind including reasonable attorneys’ fees. This waiver applies even though said liability may arise out of negligence or carelessness on the part of the Organization, except that I will have no obligation to indemnify the Organization to the extent that any claim of a third party arises solely from the intentional and willful misconduct of the Organization. This document shall be binding upon my heirs, representatives, successors and assigns and shall be construed in accordance with the laws of the State of Indiana. If any provision in this document is held to be unenforceable, it is agreed that the remaining provisions hereof shall continue in full force and effect.

  • Program Information

  • Registration Fee:

    Summer Session 1: (May 28 - June 28, 2023) $100.00 per child

    Summer Session 2: (July 1 - August 2, 2023) $100.00 per child

    * Families attending both sessions will be credited half of their reg fees back to go towards July tuition

    * All registration fees are non-refundable

    Tuition:

    Payment can be in cash, check, or through Brightwheel. Checks can be made out to Kids Connection.  You can send the check in with your child or mailed to Kids Connection, 600 Simmons St, Plainfield, IN 46168.

  • We would like to use pictures of the Kids Connection students in brochures, and on the church website and Facebook page. We will not include students’ names or any other information.

  • I understand that I will be notified of {childsName} acceptance into the KIDS@PUMC Kids Connection Program via email.  

    I agree that upon {childsName} acceptance into the KIDS@PUMC Kids Connection program, I agree to pay a NON-REFUNDABLE registration fee of $100 per child in the Kids Connection office (Room 210) or online via Brightwheel before 6:00 pm the next business day.

    I will also provide a completed emergency form/liability waiver and field trip permission slip no later than the first day of the summer program.

    Please make checks payable to Kids Connection.

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