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Summer Camp Application
  1. CAP Kids & Kritters Camp is for boys and girls enrolled in grades First through Eighth between the ages of 6-14 years old. Each week-long session takes place Monday through Friday from 8:30 am to 12:00 noon at the CAP Animal Shelter & Pet Adoption Center located on I-10 west near Barker Cypress.

    Payment information will be collected once it is confirmed that space is available for the week(s) you have chosen.

  2. Participant Information
  3. Child's First Name(*)
    Enter Child's First Name
  4. Child's Last Name(*)
    Enter Child's Last Name
  5. Child's Birthdate
    / / Enter a valid birthday for your child.
  6. Age(*)
    Enter Child's Age
  7. Grade (Fall 2019)(*)
    Enter Child's upcoming Grade
  8. Gender(*)
    Select Child's Gender
  9. Address(*)
    Please enter your address
  10. City(*)
    Please enter a valid city.
  11. State(*)
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  12. Zip Code(*)
    Please enter a valid zip code.
  13. Shirt Size(*)
    Select your Child's Shirt Size
  14. My Child is Registering for the following Camps:(*)

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  15. Registrations are accepted on a first-come, first-served basis, and space is limited. Registration for a particular session is not guaranteed until confirmed by CAP staff. You will receive a letter of confirmation when your registration is accepted and paid in full.

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  17. Parent Information
  18. Parent/Guardian 1 First Name(*)
    Please add your first name.
  19. Parent/Guardian 1 Last Name(*)
    Please add your last name.
  20. Address(*)
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  21. City(*)
    Please enter a valid city.
  22. State(*)
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  23. Zip(*)
    Please enter a valid zip code.
  24. Home Phone(*)
    Please add your home phone number.
  25. Cell Phone
  26. Work Phone
  27. Email Address(*)
    Please enter a valid email address
  28. Parent/Guardian 2 First Name
    Please enter a second Parent/Guardian's first name.
  29. Parent/Guardian 2 Last Name
    Please enter a second Parent/Guardian's last name.
  30. Address
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  31. City
    Please enter a valid city.
  32. State
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  33. Zip
    Please enter a second Parent/Guardian's zip code.
  34. Home Phone
    Please enter a second Parent/Guardian's home phone number.
  35. Cell Phone
  36. Work Phone
  37. Email Address
    Please enter a second Parent/Guardian's email address
  38. Marital Status
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  39. Health Information

  40. Is your child taking any medications?(*)
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  41. If so, please list and explain:
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  42. Status of your child’s vision, hearing, and speech:(*)
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  43. If your child has any of the following, please explain:
  44. Dietary restrictions/allergies:
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  45. Asthma:
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  46. Special Needs:
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  47. Significant information about your child’s behavior that would be helpful to know: This information is kept confidential and will be used only to help us accommodate your child’s needs and provide the best possible camp experience for him/her.
  48. Behavior
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  49. In Case of Illness:

    If a child is sick with a communicable disease or with a fever, the child cannot attend camp for that day. If the illness persists for more than one day, a medical release must be turned in by the parent/guardian before the child returns back to camp. In the event that a child in unable to return to complete the camp there will be no refunds.

    I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me.

  50. Parent Signature(*)
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  51. Emergency Contacts

    If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact?
  52. Name - Primary Contact(*)
    Please enter a name for first emergency contact.
  53. Phone - Primary Contact(*)
    Please enter a phone number for your first emergency contact.
  54. Name - Secondary Contact
  55. Phone - Secondary Contact
    Please enter a valid phone number for your secondary emergency contact.
  56. Authorized Transportation

    I hereby authorize Citizens for Animal Protection to release my child/children to the following person(s) (you will be asked to provide Driver's License information upon acceptance).
  57. Name - Primary Pickup
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  58. Phone - Primary Pickup
    Enter a valid phone number for your first alternative pickup contact.
  59. Name - Secondary Pickup
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  60. Phone - Secondary Pickup
    Enter a valid phone number for your secondary alternative pickup contact.
  61. If anyone other than those listed above is to pick up my child, I need to notify Citizens for Animal Protection Kids & Kritters Camp staff in writing and supply the staff with the name and driver's license number of the authorized adult.
  62. Registrations are accepted on a first-come, first-served basis and space is limited. Registration is not guaranteed until confirmed by CAP staff. You will receive a letter of confirmation via email when your registration has been accepted and paid in full. Each week of camp is $250.00.

  63. Waiver of Liability and Permission Form
    I understand that my child will be participating in activities at Citizens for Animal Protection (CAP) and that in the course of such activities the child will have direct contact with various animals.
    I further understand that while all precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing the risks of interacting with animals, on behalf of my child and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any of its officers, directors, employees, agents, or contractors for any and all personal injury or property damages resulting from my child’s participation in camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities.
    I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP.

    Print Name Below to Approve
  64. Waiver of Liability(*)
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  65. Release for Photographic and Digital Images
    I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use.

    Print Name Below to Approve or Type No to Decline
  66. Release for Photos(*)
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  67. Submit Your Application
  68. CAPTCHA Security Code(*)
    CAPTCHA Security Code
    Enter black letters from security code.