I, the undersigned parent or legal
guardian of above named children will not hold Kaleidoscope,
its agents, servants or employees responsible for any
accidents incurred during participation in the Kaleidoscope
program. If parents or doctor cannot be reached in case of
emergency, consent is hereby given that the student receive
medical treatment and/or surgical care as recommended by
physician or hospital.
Your typed name is considered your
|How did you hear about us?
Please click the submit button below to send your
registration or print and then fax or mail this form.
If check is not mailed within 24 hours, registration
cannot be confirmed.
Please make checks payable to KALEIDOSCOPE and mail
ANDOVER, MA 01810
Please call (978) 475-1422 days, nights and weekends and
leave a message.
Print a copy of this form now for your records
Note: If you are using the PayPal option, please
click submit first, then the PayPal link in the