Summer K.A.R.E. Camp Registration

Camper Information
Name*
First Last
Nickname
Birthdate (mm/dd/yyyy)*
MM slash DD slash YYYY
Gender*
Grade Entering Fall 2024*
School Attending Fall 2024*
Camper T-shirt Size*
How did you hear about us?

Primary Contact Information
Primary Contact Name*
First Last
Mobile Phone*
Email*
Address*
Street Address City State ZIP Code

Health Information
Does your child have chronic health concerns like asthma, diabetes, or headaches?*
- Yes
- No
Any physical limitations?
- Yes
- No
Are there any behavioral medications or psychological issues of which the camp should be aware?
- Yes
- No
Allergies?*
Diet and nutrition*

Waivers and Releases
Photography and Video Release*
I accept
In consideration of the acceptance for the above program, the legal Parent /Guardian or as the person with express authority from the legal Parent/Guardian (the “Parent/Guardian”) of the participant or participants, such as a minor child or children, and as an Associate, including but not limited to an employee, volunteer, chaperone, etc., in Kids Who KARE Camp, LLC’s programs agree to allow Kids Who KARE Camp, LLC and its photographers and/or videographers to photograph or videotape them participating in the programs during the general sessions and breakouts, including but not limited to the training rooms and all common areas. Kids Who KARE Camp, LLC reserves the right to use the likeness of the minor child or children participant(s) and Associates without compensation in subsequent print and/or electronic publications, promotional/marketing materials, and/or on the Kids Who KARE Camp, LLC’s website. If you do not wish for the minor child or children participant(s) or as an Associate to be photographed or videotaped at the programs, please notify us in writing before any scheduled event(s).
Publicity Waiver and Release*
I accept
In consideration of the acceptance for the above program, the legal Parent/Guardian of the minor child or children or as the person who has express authority from of the legal Parent/Guardian of the minor child or children (the “Parent/Guardian”) and any other person(s) associated with Kids WhoKARE Camp, LLC, including but not limited to employees, volunteers, chaperone, etc. (“Associate”and/or “Associates”) hereby permits and authorizes Kids Who KARE Camp, LLC (the “Camp”), and its employees, agents, and representatives, as well as its affiliates, successors, and assigns, (“Authorized Persons”), to use the name, image, likeness, appearance, voice, and other personal characteristics (collectively, “Likeness”) of the minor child or children in all materials created by or on behalf of the Camp that incorporate their Likeness(“Materials”), for advertising, promotion, and any other commercial or lawful purposes, and to use and license others to use their Likeness in any medium or format whatsoever, now existing or hereafter created, including but not limited to, in and on print, video presentations, television, radio, news bulletins, mailers, brochures, billboards or signs, other print publications, website placements, video, blogs, social media, podcasts, and other digital delivery and electronic media, as well as any other advertising and promotional materials, without further consent from theParent/Guardian and Associates or any royalty, payment, or other compensation to the Parent/Guardian and/or the minor child or children and Associates.

Parent/Guardian and Associates understand and agree that the Materials will become the sole and exclusive property of the Camp. The rights granted under this release include all current and future intellectual property rights in the Materials which may contain the Likeness of the minor child or children and Associates.

Parent/Guardian andAssociates hereby irrevocably transfer and assign to the Camp the entire right, title, and interest, if any, in and to the Materials and all copyrights in the Materials arising in any jurisdiction throughout the world, including the right to register and to enforce such copyrights against infringers.

Parent/Guardian and Associates acknowledge and agree that they have no right to review or approve any Materials before they are used by the Camp, and that the Camp has no liability to them for any editing or alteration of the Materials or for any other effects resulting from the Camp’s editing, alteration, or use of the Materials. The Camp has no obligation to use the Materials or to exercise any rights given by the Agreement.

In addition, Parent/Guardian and Associates hereby waive any rights of privacy, publicity, copyright, or any similar claim or cause of action in tort, contract, or any other legal theory, associated with the minor child or children’s and/or Associates’ Likeness, as well as the right to inspect or approve the finished product wherein the minor child or children’s and/or Associates’ Likeness appears. Parent/Guardian and Associates waive any right to royalties or other compensation arising out of or related to the use of the minor child or children’s and/or Associates’ Likeness by the Camp. Parent/Guardian and Associates hereby forever release, hold harmless, and discharge the Camp from any claims, actions, demands, and/or causes of action which Parent/Guardian and/or Associates’, their heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of their estate have or may have by reason of this authorization. Parent/Guardian and Associates hereby covenants not to make or bring any such Claim against any Authorized Persons and Parent/Guardian and Associates forever release and discharge the Authorized Persons from liability under such Claims. There is no time limit on the validity of this Publicity Waiver and Release, nor is there any geographic limitation on where the Materials may be distributed.
Name*
First Last
Date*
MM slash DD slash YYYY
By entering my name and the date, I give you my electronic signature.

You’re almost done! A few important notes for families.
In addition to hands-on service projects and volunteering, there are two other important parts of your camper’s experience:
Donations of critically-needed items*
- Yes, Got It!
Friday FUNdraisers*
- Yes, Got It!

Donations Of Critically-Needed Items
Prior to camp, families receive a list of critically-needed items, as supplied from our Summer Partners. In the past, these lists included items such as canned goods, diapers, pet food, school supplies, old blankets, etc. To the extent your family is comfortable, campers can bring donated items for their week to camp (preferably on Mondays) for delivery to partners as they visit. A typical session’s donations posts approx. $25-$50. Your camper will earn an additional hour of service for each $10 of donated goods, based upon industry guidelines. It is highly recommended that your camper shops and selects items with you.
I understand that bringing critically needed items for donation to partners is recommended and optional.
- Yes, Got It!
I also understand that this element of camp makes a big impact, and every little bit helps.
- Yes, Got It!

Friday FUNdraisers!
The last day of their camp session is the day of their Friday FUNdraiser, and it is a camper favorite. It is dedicated to a cooperative project which is discussed, planned, and led by the campers all week to raise money for our non-profit partners. After fundraiser clean up and before goodbyes, each camper designates where they would like their portion of proceeds to be directed. It is K.A.R.E. Camp’s preference, but not required, that they choose a charity they met during their camp session. Donations are combined from all summer sessions and donation visits are scheduled between August-October. Campers are invited and encouraged to join those visits. Each visit is designed for campers to earn additional service hours.
I understand that my camper(s) may need some assistance from me prior to, or during, camp regarding raising donations for non-profit partners and promoting their Friday FUNdraiser.*
- Yes, Got It!
I understand that to support their Friday FUNraiser, I will help promote the event to my friends, neighbors, and family networks.*
- Yes, Got It!
I understand that Friday FUNdraisers is an important part of camp, and every little bit helps.*
- Yes, Got It!

Camp Selection and Payment
Please select the camp session. If you are registering for more than one child, please complete this form for each child.
Summer K.A.R.E. Camp Session*
Have a promo code? Enter it here:
Would you like us to pre-buy your donated items? These items are donated during the week during visits.*
- Yes, add $25 for donated items.
- No, I will bring donations to camp.
Total
$0.00
Please note: Your camp reservation will be held for 7 days. If payment has not been received within 7 days, your spot will no longer be reserved. You must re-register and re-confirm availability.
Payment Method*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

Summer K.A.R.E. Camp Registration

Step 1 of 8

Camper Information

Primary Contact Information

Health Information

Waivers and Releases

You’re almost done! A few important notes for families.

Donations Of Critically-Needed Items

Friday FUNdraisers!

Camp Selection and Payment