KiiNNECT Youth Summer Camp Registration Form

KiiNNECT Youth Summer Camp Registration Form

At KiiNNECT, we believe every child deserves opportunities to build creativity, confidence, connection, and a sense of belonging. Our camps combine art, movement, games, outdoor exploration, teamwork, and social emotional learning in a fun, supportive environment where youth can express themselves, make friends, develop leadership skills, and discover new possibilities. Whether your child loves creating, building, exploring, playing, or simply trying new things, our programs are designed to nurture curiosity, confidence, collaboration, and joy.
This registration form includes all KiiNNECT Summer 2026 programs. You may register for one or multiple camps. Registration typically takes 5–7 minutes to complete. Please select your preferred camp weeks, review the waiver and consent, and proceed to payment.
Weeklong Camps in the Bay Area, CA (Options, Full 9-3p $650, or Half day 3hr $325)
- Week 1: M-F, July 6 - July 10, (South Bay, Vasona County Parks)
- Week 2: M-F, July 13 - July 17 (East Bay, Point San Pablo Harbor)
- Week 3: M-F July 20 - July 24 (East Bay, Point San Pablo Harbor)
Child Name

First NameLast Name
Child's Preferred Name
Optional
Child Pronouns
Optional
Child's Age

MonthDayYear
Date
Grade in Fall '26–'27 School Year
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Allergies / Medical Considerations
Authorized Pickup Contact(s) and Phone Number(s)
Photo & Media Release.

We love sharing the creativity, learning, and community that happen during our programs. Photos and videos help us document the experience, celebrate participants, and support future programming.

KiiNNECT may photograph, video record, or capture audio during camp for educational, storytelling, community-building, and promotional purposes, including use on our website, social media, newsletters, grant reports, and related materials.We will make reasonable efforts to avoid sharing identifying personal information without additional consent.
Which tier is your family comfortable with?
Do you give permission to use your child's pictures in camp activities, such a making their own storybook with their pictures as part of the illustration?
Refund & Cancellation Policy
- 21+ days before camp: Refund minus a $100 administrative fee
- 14–20 days before camp: 50% refund
- Less than 14 days before camp: No refund
- Registrations may be transferred to another child up to 7 days before camp with approval from KiiNNECT
- If KiiNNECT cancels a session, families will receive a full refund.
I certify that I am the parent or legal guardian of the child listed on this registration form and agree to the Participation & Safety Agreement, Medical Authorization, Behavior Expectations, Refund Policy, and any selections made.

My Products

7/6-7/10 Half-Day Vasona County Park

Half day 9-12p or 12-3p

$325.00

7/6-7/10 Full Day 9-3p, Vasona County Park

$650.00

7/13-7/17 Half-Day, Point San Pablo Harbor

Half day 9-12p or 12-3p

$325.00

7/13-7/17 Full Day 9-3p Point San Pablo Harbor

$650.00

7/20-7/24 Half-Day Point San Pablo Harbor

Half day 9-12p or 12-3p

$325.00

7/20-7/24 Full Day 9-3p Point San Pablo Harbor

$650.00

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

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KiiNNECT Youth Summer Camp Registration Form

My Products*

My Products