Heluhelu ʻĀina (Spring Day Camp 2020)

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PREREGISTRATION DUE BY MARCH 9, 2020
PreRegistration Pricing: $300 +$50 supply/travel fee
(After March 9: $350 +$50 supply/travel fee)
Dates: March 16 - 20, 2020
Times: 8:00 am - 1:00 pm
Pick Up/Drop Off Location: Hale Hinano 250 Alamaha st. Ste. N6 Kahului, Maui 96732
Contact: Sarah at kumu@ku1ko.com

Please fill out (1) form per keiki.

Kumu Hula Joy Salvador
Kumu Sarah Nāone
Ku1ko

Child's Name (Last, First, M.I.) *

Child's Age *

Child's Birthdate *

YYYY

Child's Grade *

Child's Gender

Female

Male

Prefer not to say

Other:

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Child's School

Parent/Legal Guardian Name (Last, First, M.I.) *Authorized to pick up child* *

Parent/Legal Guardian Work Phone *

Parent/Legal Guardian Cell Phone *

Parent/Legal Guardian Email *

Parent/Legal Guardian Name (Last, First, M.I.) *Authorized to pick up child*

Parent/Legal Guardian Work Phone

Parent/Legal Guardian Cell Phone

Medical Conditions/Allergies *

Authorized Pick-Up and Emergency Person (Other than parents/legal guardians)

Relationship to child

Cell/Work Phone

Child's T-Shirt Size *

YXS

YXL

XXL

Other:

Is your keiki a member of Hālau Keʻala Kahinano o Puna or other Ku1ko related activities (i.e. Moʻomeheu, Kāne Hula)? *

Yes

I understand that my child must bring a healthy snack, full water bottle, and healthy lunch daily. *

Yes

I understand that I will be invoiced through PayPal when this registration form is received. Payment must be received within (7) business days of program start date. Registration form must be received by Monday March 9, 2020 to be eligible for special pricing. *

Yes

I hereby give my child permission to attend and participate in the activities conducted by Kukahiko LLC (also known as Ku1ko). These activities include aquatics, off-property excursions, transportation, and enrichment activities. I hereby authorize Kukahiko LLC (also known as Ku1ko) to use my child’s name and video or photograph at anytime and in any manner in connection with its advertising, publicity, and public relations programs. The video-photo may only be used by Kukahiko LLC(also known as Ku1ko). Kukahiko LLC (also known as Ku1ko) reserves the right to refuse child's participation in its programs at any time. (Type your name below to grant permission to the aforementioned statements.) *

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