Today's Date
Dates
Kidizens offers After Care from 3pm to 5pm at $35 per child, per day. For this camp, please indicate which days, if any, you will be needing After Care.
Health Information
Medical Information
Please, indicate what we should do in the event of accident or emergency:
If you chose "OTHER" as the option above, please write the action to be taken below:
Additional Pickup Authorization
Covid Parent Consent Form
CORONAVIRUS / COVID-19 WARNING & DISCLAIMER: The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is an extremely contagious virus and is believed to spread mainly by person-to-person contact. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Furthermore, the risks of COVID-19 are not fully understood and there is controversy among experts as to how the virus can spread and there is difficulty in scientifically determining whether someone has the virus at any moment in time. Kidzz, Inc. (DBA as Kidizens) has put in place certain preventive and safety measures to reduce the spread of COVID-19. However, Kidizens cannot guarantee that your child will not become infected with COVID-19 through participation in any of its camps or any activities (including, but not limited to workshops, birthday parties, Club Kidizens and more).
Read carefully before marking each box.
Covid Parent Waiver & Release Form
WAIVER, RELEASE, INDEMNIFICATION & COVENANT NOT TO SUE: In consideration of my child’s participation in activities and programs, I, the undersigned, agree to INDEMNIFY AND HOLD HARMLESS Kidzz, Inc., (DBA Kidizens) from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out of or in any way related to my child’s activity and program participation. I hereby certify that I have full knowledge of the nature and extent of the risks inherent in any activity and program participation and that I, on behalf of myself and my child, am voluntarily assuming said risks. I understand that I and my child will be solely responsible for any loss or damage, including personal injury, property damage, or death, sustained while participating in any activities and programs with Kidizens, and that by signing this agreement I, on behalf of myself and my child, HEREBY RELEASE Kidizens, its agents, employees, volunteers and representatives, of all liability for such loss, damage, or death.
I further understand that the terms of this agreement are legally binding and certify that I am signing this agreement, after having carefully read it, of my own free will.
NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document carefully and in its entirety. By initialing below, you give up your right and your child’s right to bring a court action to recover compensation or obtain any other remedy for any personal injury or any damage however caused arising out of your child’s participation in Kidizens programs or activities, now or any time in the future.
Other Waivers & Information
Digital Safety and Access: Your children may need and gain access to Internet as well as use Kidizens laptops and iPads for camp-related research, help with writing speeches, public campaigning ideas, and for end-of-class LEGO movie production. While we strive to create a positive culture that supports safe and responsible technology and Internet access as well as monitor all device usage, we want to ensure that you also have spoken to your children about Internet safety, appropriate device usage and good digital citizenship. My child has permission to use the Kidizens iPads and computers on the premises and is allowed to log on to the Internet for class-related research purposes.
Disciplinary Policy: Kidizens holds a high standard of conduct and learning in all its programs. If a child’s behavior is disruptive and impedes the fun and learning for other students, then Kidizens reserves the right to take a disciplinary action in accordance with the Kidizens philosophy. The Kidizens Teachers will consult with the parent and child to come to an agreement on what actions need to be taken to minimize any disruption. This action may include dismissal of a child from the program without any refunds.
Parent Acknowledgement and Agreement: I state that I am the parent and/or legal guardian of the student(s) I am registering. As the parent of authorized representative, I hereby give consent to have my child attend the Kidizens Classes, Camps and workshops held at Los Altos, Belmont, or other Kidizens off-site locations. I will not hold Kidzz, Inc., Kidizens and its staff liable for any accidents, physical or other injury and from any and all claims, demands, costs, expenses, and compensation arising due to that. *
Confidentiality Agreement: Kidizens will be sharing some of its proprietary curriculum and copyrighted materials. You agree not to share or distribute any of these resources. *
I allow my child to be a part of a photo/video shoot that may be done during this session: *
Please keep me updated on Kidizens news and registration deadlines
Please sign your full name below to confirm and agree to all of the above terms. *
