Kiddie Korner 2025 Camp Registration
A $100 registration fee and $10 camp t-shirt fee via PayPal required. You will be directed there upon completion of this form. Please call (718) 596-4840 for assistance.
Child's Name*:
Child's Hebrew Name: (If inapplicable type "N/A")
DOB (MM/DD/YYYY format)*:
Gender:
Home Address*:
ZIP*:
Home Phone*:
Cell Phone:
Child Lives With*:
Child's Age by September 2025: Years Months
Father's Name*:
Father's Hebrew Name: (If inapplicable type "N/A")
Home Address (If Different From Above):
Cell Phone*:
Occupation:
Position/Title:
Work Phone:
Work/Business Address:
Email*:
Mother's Name*:
Mother's Hebrew Name: (If inapplicable type "N/A")
Home Address (If Different From Above):
Cell Phone*:
Occupation:
Position/Title:
Work Phone:
Work/Business Address:
Email*:
Previous/Current School or Playgroup*:
May we have permission to contact them?
Contact Number*:
Language/s Spoken At Home:
Language/s Spoken By Child:
Name/s, Birthday/s, and School/s of Sibling/s:
Special considerations, if any:
How did you hear about Kiddie Korner day camp?
Please select session/s: click here for price schedule
June 30 - July 11 (2 week session)
July 14 - July 25 (2 week session)
July 28- August 15 (3 week session)
All 3 sessions
Please Select Which Program:
Note: We do not offer the half day program (9am - 12pm) option for children that are 4 or 5 years old, due to their schedules including special trips and programs.
All 5 Days (of the week)?
If Only 3 Days, Please Specify Which (M, T, W, TH, F format):
T-shirt size:
Number of t-shirts (please note: ordering more than one t-shirt is only possible if you are registering at least two weeks in advance of camp):
Do you consent to allow your child to participate in supervised curricular and extracurricular activities that may include leaving the building?
I am fully aware that in case of extended closures due to COVID-19 cases, a pandemic, or any public health emergencies that may arise during summer camp or regular sessions, Kiddie Korner Preschool will not refund any tuition or deposit fees that were made prior to the school's closure. In addition, any new registrations will not be refunded, even if the child did not begin care.
By typing your name, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Form.
Signature of Parent*:
Would you like to receive emails about our future programs in the Preschool and Synagogue?
Prior to submission, you will be directed to PayPal to pay the $100 registration fee and $10 camp t-shirt fee.
