K a l e I d o s c o pe
Early Childhood Development Center
165 Prospect Park Southwest, Brooklyn, NY 11218
480 Stratford Road, Brooklyn, NY 11218
718-436-1421
Summer 2017 Registration Form
Kaleidoscope Summer Program is a fun and recreational program for 2-5 year olds with special interest in the arts. The program is focused around a theme, which is explored through storytelling, singing, music, dancing, art projects and lots of group games.
Daily outdoor activities, nap (for preschool and pre-K to be), and meals are included. Summer Camp Cap (a must to have for Windsor Terrace preschool and children born in 2012 and 2011 for Ditmas Park preschool) is an extra cost.
Summer Program runs Monday through Friday, May 30, 2017 to August 18, 2017.
Registrations will be accepted on “first come first served basis” beginning on Monday, February 6h, 2017
Site / Cost per week for children born in 2012 and 2011 / Cost per week for children born in 2013 and 2014 / Extended Summer Program08/14 – 08/18
Windsor Terrace site
at 165 Prospect Park SW / $250 / $300 / $350
Ditmas Park site
at 480 Stratford Road / $250 / $285 / $350
The week of May 29 and the week of July 3 is $220 each for both locations.
The program regular hours are 9:00am to 4:00pm. Extended hours are available for $9 from8:00 am – 9:00 am and $17 from4:00 pm – 6:00 pm.
Discounts
Sibling - receive 10% off from the 2nd sibling fee
Bring a friend – receive $25 off your registration
Discounts cannot be combined
Two convenient camp locations are available.
Windsor Terrace Kaleidoscope Program Ditmas Park Kaleidoscope Program
165 Prospect Park Southwest 480 Stratford Road
Brooklyn, NY 11218 Brooklyn, NY 11218
Summer 2017 Registration Form
Child’s Information
First Name ______Last Name______Date of Birth ___/___/______Gender______
Child’s home address ______Home Phone ______
Parent/Guardian Information
Name of Parent or Guardian______
Street Address ______City ______Zip ______
Home phone______Cell phone ______e-mail______
Name of Parent or Guardian______
Street Address ______City ______Zip ______
Home phone______Cell phone ______e-mail______
I am interested in
Weeks / Regular Day9:00 am – 4:00 pm / Morning
8:00 am – 9:00 am / After School 4:00 pm – 6:00 pm / Total Fees
May 30 – June 2
June 5 – June9
June 12 – June 16
June 19 – June 23
June 26 – June 30
July 3 – July 7
July 10 – July 14
July 17 – July 21
July 24 – July 28
July 31 – August 4
August 7 – August 11
August 14 – August 18
Sibling Discount
Referral Discount
Total Fees
Parent/Guardian Name ______Signature ______Date ______
Camp Registration Policies
A non-refundable $300 deposit (is applied to summer fee) along with the $50 registration fee (for new students only) is due with your registration form. Camp balance is due by May 1, 2017. In the event this registration is filled after May 1, 2017, the entire amount is due with the application
A standard Department of Health Medical Form must be submitted to the camp by May 1, 2017. Medical form and Emergency Authorization Form must be completed and submitted prior to the child's admission to the program. No camper may attend camp without the completed Medical Form and Emergency Authorization Form.
Late pick-up policy fee: For pick-up after designated time, a fee of $1 per minute will be charged.
If a participant displays inappropriate behavior, or endangers the health and safety of participants or staff, we will contact theparent/guardian to immediately come to the site. We may suspend the participant from the program or consider permanent termination in extreme situations.
Cancellation and Change Policy
If you must cancel your registration you will be eligible for a full refund (minus a $50 registration fee and non-refundable $300 deposit) if the cancelation is made at least 8 weeks before the camp starting date. Cancellations received with less than 8 weeks’ notice will not be eligible for any refund. If you would like to reschedule your camp week, a $50 processing fee will be charged and changes will be accommodated only when there is space available. All payments are non-refundable after April 1, 2017.
No refunds or adjustments will be made for incidental absences including, but not limited to illness or failure to provide a medical form.
Medical Release Information
Primary emergency contact name ______Daytime phone ______Relationship______
Secondary emergency contact name ______Daytime phone______Relationship______
Doctor’s name______Doctor’s phone ______
Does your child have any allergies, medical conditions, or other special needs? Please, specify what your child is allergic to and what reaction is typical. ______
I do hereby give authority to the day camp and staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible.
Image Release
By enrolling your child in ECDC Kaleidoscope programs, you authorize that photographs, motion pictures and/or video recordings taken of him/her during his/her participation in an ECDC Kaleidoscope program may be used by ECDC Kaleidoscope for its publicity purposes including but not limited to newsletters, brochures, websites, and videos.
Transportation Release (for children born in 2012 and 2011)
I give permission for ECDC Kaleidoscope to provide or attain transportation for my child in order for them to participate in ECDC Kaleidoscope trips.
I have read the terms of enrollment and other related information and agree to accept all terms as set forth above.
Child’s Name ______Camp Program ______
Parent/Guardian Name ______Signature ______Date ______