One moment please...
Konnichiwa Summer! Japanese Jamboree Camp
Parent Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Cell Phone
*
Home Phone
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Child Information
Summer Camp
*
Group One: July 16–20, Ages 6–10
Group Two: July 23–27, Ages 11–14
Summer Camp, July 16–20
*
Quantity
$85
-
Group One: Ages 6–10
0
1
2
2
Summer Camp, July 23–27
*
Quantity
$85
-
Group Two, Ages 11–14
0
1
2
2
Child's Name and Age
*
Second Child's Name and Age
*
Second Child's Name and Age
*
Does your child have any allergies we should be aware of?
Is there any additional information about your child that we should be aware of?
Consent Waiver
*
By checking this box you give the World Affairs Council the right to use your child’s visual image to promote the program in electronic and print publications, social media and website. If you do not consent to the use of your child’s image, please contact Ayako Nakajima, ayako.nakajima@worldkentucky.org
*
By checking this box you recognize that you, as your child's parent or guardian, are responsible for all transportation to and from the Konnichiwa Summer! Japanese Jamboree Summer Camp.