Children's Kindness Camp

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Children's Kindness Camp - Registration

Hosted by the First Congregational Church of Haddam and Higganum Congregational Church
Camp location: FCCH 905 Saybrook Road, Haddam CT 06438

Monday August 15 through Friday August 19, 2022
Program Hours: 9am to 12pm
Program Fee: $50 per child* - five days of program
Ages: 4 to 12 years old
Early Drop-Off and Afternoon Care Option: $50 per child additional fee
Drop-Off begins 7:30a, Last Pick-Up 4p

*Scholarships available for those in need.

VOLUNTEERS NEEDED - please let us know if you are willing to volunteer for any part!
GOT TEENAGERS? - we will gladly sign community service forms for students that help
GOT ADDITIONAL QUESTIONS - please reach out if you have questions or comments.

We are committed to implementing a program that helps local families during this specific week of the summer when most camps have ended, and school hasn't started yet. If you have additional schedule needs, please reach out so we can try to work with you to help with the coverage you need.

More program details will be available when program registration begins.

Parent(s) Name *

Email Address *

Street Address *

Town and Zip Code *

Home Phone Number *

Work Phone Number *

Cell Phone Number *

Number of children to enroll *

Names, ages and school grades of children *

T-shirt size for each registering child *

Requested camp timeframe *

9a-12p program only

early morning drop off (7:30-9a) and 9a-12p program

9a-12p and afternoon care (up to 4p)

full day option (7:30a-4p)

Medical conditions/allergies for each child *

Emergency Contact #1

Please list Name, Phone Number and Relationship to Child

Emergency Contact #2

Please list Name, Phone Number and Relationship to Child

If your child requires an epi pen and can not administer it themselves, do you give permission to an adult camp leader who has the proper training to administer that child's epi pen? *

Yes

N/A

In the event of an emergency, and we feel it is necessary to transport your child to the hospital, we will choose the closest hospital available - Middlesex Hospital. Do you have an alternate hospital that you would prefer your child to be transported to in the event that we can not get in contact with you OR your designated emergency contact? *

No - please consider Middlesex Hospital as my directed facility choice

Yes - I would like my child transported elsewhere (please include in comments below)

Are there any persons that are NOT permitted to pick up the child?

Yes (please include in comments section below)

May we photograph or video your child(ren) as part of the camp group and post these photos in our facilities at FCCH or HCC (such as fellowship hall, church offices) or on social media and websites? *

Please note that names will be included in any publication of these images.

Yes - I give permission to take photographs or videos of my child(ren) for these purposes.

No - please refrain from all photographs or videos of my child(ren)

Are you interesting in volunteering to help with CKC?

Yes, please contact me with more details

Clear selection

Parental consent for registration and agreement to pay as per fees listed above.

Please type full name, date and relationship to child(ren)

Please contact me about scholarship assistance *

Additional comments/information you would like to share about your child/children? Is there any information that would help us to make them feel comfortable?

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