KidzJet Adventures Registration

Student Information

What theme and week are you applying for?
Are you a new or returning student?
Student Name
Date of Birth
Student Age
Pick up/Drop off Location
Parent First Name
Parent Last Name
Primary Phone
Secondary Phone
Please describe pertinent medical history including allergies, dietary restrictions,chronic/long-term illness or injuries, or state "none"

If none, please enter "none"

Are you (your child) currently taking any medications? If yes, please specify.
Emergency Contact
Emergency Contact Relation
Emergency Contact Phone
Emergency Contact #2
Emergency Contact #2 Relation
Emergency Contact #2 phone
Family Physician
Family Physician Phone
Medical Insurance Provider
Insurance Provider Phone
Insurance Policy Number
Type of Coverage

Authorization and Waiver


I verify that the above information is complete and accurate. I understand measures will be taken to safeguard the health and safety of all participants; however, in the event of need I hereby grant permission of the KidzJet or its authorized representatives to arrange for such medical care that I (or my child) may require. This includes minor medial care in the field by KidzJet staff members, which may include the administration of over the counter medications if needed. I also authorize KidzJet staff to administer prescription medications provided by the parent or guardian as needed by the child/ward during the program. In the event of serious injury or illness or the need for hospitalization and/or surgery, KidzJet will use all reasonable efforts to contact the parent, guardian and/or people listed as emergency contacts. In the event contacts cannot be reached in an emergency I authorize the KidzJet in arranging emergency treatment that may be necessary. I am aware that the KidzJet assumes no liability for the costs or provision of evacuation and medical care in the event that care is needed during or after this program. If I (or my child) have a medical condition, I (or my child) have been seen by a physician who is aware of my present condition, health history, and trip details and recommends that I (or my child) be able to fully participate.

I have read and agree to these conditions

As participant or parent or guardian (“Releasor”), I acknowledge that I have voluntarily enrolled myself and/or my child (individually or collectively ”Participant”) in a program that may involve activities that can be considered hazardous and present possible risk including, but not limited to on and off trail hiking, travel in vans, camping, knife use, and remote area travel. Participant is voluntarily participating in any Program with knowledge of the danger involved. Participant understands that it is his/her responsibility to obtain a physical examination from a medical doctor to determine his/her present health and medical condition before beginning program. By placing my initials below, Participant hereby agrees to accept any and all risk of injury or death to Participant relating to any KidzJet program or use of the their facilities. As consideration for being permitted by the KidzJet to participate in any of the Programs and use of facilities, I hereby agree that I, my assignees, heirs, distributees, guardians, and legal representatives or my enrolled child or such enrolled child’s assignees, heirs distributees, guardians and legal representatives will not make a claim against, sue, or attach the property of the KidzJet and any of its affiliated organizations for injury or damage resulting from the negligence or other acts, howsoever caused, by any employee, agent, or contractor of the KidzJet or any of its affiliated organizations as a result of my participation in any of the Programs. I hereby release the KidzJet and any of its affiliated organizations, its employees and agents from all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, and legal representatives or that my enrolled child or such enrolled child’s assignees, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my or my enrolled child’s participation in any of the KidzJet Programs. Participant agrees that he/she will abide by all rules and regulations regarding any of the Programs that may be established by the KidzJet or its agents. Participant understands and agrees that if the KidzJet or any of its agents determines that Participant has violated any of the KidzJet rules or regulations, Participant may immediately be discharged from any of the Programs and the KidzJet facilities without any reimbursement for any payment to the KidzJet. Participant has carefully read this agreement and fully understands its contents. Participant is aware that this is a release of liability and constitutes a contract between Participant and the KidzJet and/or it’s affiliated organizations, and executes it voluntarily. This constitutes the entire agreement between Participant and the KidzJet regarding the subjects contained in this Agreement, including assumption of risk, release from liability and compliance with the KidzJet rules and regulations. This agreement may only be amended in writing, signed by Participant and an executive officer of the KidzJet.

I have read and agree to the conditions of this release from liability

I hereby grant free permission for The KidzJet to use images of myself participating in their programs or events for outreach purposes, including but not limited to electronic or print materials or media. Please consider granting this release to us if at all possible, as our ability to successfully share our programs with new participants depends on having representative photographs.

I agree to photo release

It is a core value at the KidzJet, to create an environment where all students, all goals, and all interests are equally important. It is crucial that each participant (you!) adhere to the following responsibilities (Please read them carefully!)

  • All students must check in with their counselor upon arrival and check out upon departure.
  • You must take responsibility for your behavior during our programs. We expect each student to act like a responsible caretaker of the environment.
  • Cigarettes and tobacco products, alcohol, illegal substances of any kind, and weapons are unequivocally prohibited anywhere during our programs.
  • No profanity is allowed.
  • There is no comparative analysis between students at the KidzJet Adventures.
  • Our programs are designed to give your children the courage to ask questions.
  • Please always follow counselor’s instructions.

Its important to follow following guidelines when travelling in KidzJet vans

  • Courteous and respectful conduct toward the driver, other vehicles on the road as well as the passengers in the van is expected at all times.
  • Students are to remain seated and must have seatbelts fastened at all times.
  • Students should talk in normal voices and should not shout and yell.
  • Students should not harass, tease or threaten other students.
  • Students should not act in a manner that may cause harm or injury to another student or passenger.
  • Students should not act in a manner, which may cause harm or injury to another vehicle.
  • Eating or drinking is not allowed in vans.
  • Students are responsible for keeping the area they sit in clean.
  • The driver of the van will determine the riders for the trip.
  • Seat belts or child restraint chairs are required for all passengers on KidzJet vehicles. KidzJet reserves the right to terminate transportation for any child that does not cooperate with the use of seat belts or car seats
I Agree to Student Policy and Responsibilities.
  • All services are prepaid, non-transferrable and nonrefundable. Cancellation requires 30 days of notice. Once booking is made, registration fee of $100 per child is non-refundable. After 30 days, we will provide NO refunds or credit.
  • We will always strive to be on-time, however, pick up/drop off time estimates are +/- 15 minutes of scheduled time(s) and can vary based on traffic flow and weather conditions, and thus are subject to change. Other contingencies like traffic congestions, accidents along the route and other children being late can also cause delays, which are beyond our control. KidzJet shall not be held responsible for such delays.
  • KidzJet reserves the right to cancel this agreement without notice at any time due to disciplinary problems with a child while riding our vehicles.
  • KidzJet is not liable for the health, safety or welfare of your child once your child is dropped at the agreed destination.
  • Any damage to our property caused by a rider is the responsibility of the Parent/Guardian.
  • Clean up feee of $50.00 will be charged for every accident and /or illness on vehicle.

I hereby voluntarily release, hold harmless and agree to indemnify in full the KidzJet, its agents, officers, employees, successors and assigns from any and all liability, claims, demands, actions, or rights of action, which are related to or are in any way connected with my child’s participation in KidzJet Adventures program, including, but not limited to, any negligent act or omission of The KidzJet, its agents, officers or employees, successors and assigns, resulting in any and all injury to my child.

Notes to KidzJet Admin

Please let our administration know any additional needed information

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