Claremont Kids Club Summer Camp 2026 (Non-Members)

Child's Information

Camper(s) Full Name

Age/ Date of Birth

School

How did you hear about us?

Parent/ Guardian Information

Parent/ Guardian First Name

Parent/ Guardian Last Name

Street Address
Suite/Apt
City
State/Province
Zip Code
Country

Main Phone Number

Alternative Phone Number

Parent Email

Name and Cell Phone of Personnel authorized to pick up child (must present ID)

Emergency Contact Name

Emergency Contact Phone

Relationship to Child

Please note any special info here (allergies, health conditions, etc.)

Please indicate the week(s) you would like your child to attendJune 8 - June 12 - Science Week - No Longer Available – Fully Booked
June 15 - June 19 - Nature Week - No Longer Available – Fully Booked
June 22 - June 26 - Around the World - No Longer Available – Fully Booked
June 29 - July 3 - Sports Week - No Longer Available – Fully Booked
July 6 - July 10 - Circus Week
July 13 - July 17 - Culinary Week - No Longer Available – Fully Booked
July 20 - July 24 - Drama Week- No Longer Available – Fully Booked
July 27 - July 31 - Games Week- No Longer Available – Fully Booked
August 3 - August 7 - Disney Week- No Longer Available – Fully Booked
August 10 - August 14 - Mystery Week - No Longer Available – Fully Booked
August 17 - August 21 - Under the Sea - No Longer Available – Fully Booked

Please indicate which day(s) you need precare for $20/ hour

Please indicate which day(s) you need aftercare for $20/ hour

I have read and agree to the liability formYes
No

Child's health insurance carrier: (please provide policy and/or group number)

Signature

Cardholder’s Signature