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KCA Fiber Arts Club Sign Up
Club name:   Fiber Arts (creating with yarn, thread, and fabric)

Leader:          Ms. Karen Pyne

Day:                Wednesdays, after school

Dates:            October 21, 28; November 4, 11, 18; December 2, 9

Times:            3:30 - 4:30p

Cost:               $10

Minimum 3 students, maximum 10 students

Email Principal Megan Heinrich with any questions before or during the club session!

Students will be accepted to the club on a first come, first serve basis of sign up and payment. KCA clubs have a one-time $10 cost. The final step of a student's registration will be for the parent to remit payment to KCA via a link that will be emailed to the parent. Because of limited capacity, only students who receive confirmation from KCA will be registered in a club. 

All clubs are held on KCA property; are led by a volunteer or staff member who has passed a background check; are subject to student and staff policy for electronics, behavior, and emergency protocol; and are approved by the Principal.

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Parent Name *
Parent Phone *
Parent Email *
Student Name *
Student Grade
Clubs are currently available to 4th-7th graders
 *
Why are you/is your student interested in this club?  *
I understand that this club takes place after school on DAY from 3:30 - 4:30. I must come to the office (the east or parking lot side) to pick up my child from this club. *
Emergency Contact
Include name and relationship to the child
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Emergency Contact Phone *

I hereby release and discharge Kenosha Christian Academy, its promoters, volunteers, employees, and other representatives (collectively “Kenosha Christian Academy” or “KCA”) from any and all liability, claims, demands, or causes of action that the student may hereafter have for injuries or damages arising out of the student’s participation in KCA clubs, except for KCA’s gross negligence or intentional misconduct during the clubs. I further agree that I will not sue or make claim against KCA for damages or other losses sustained as a result of the student’s participation in the clubs.

I also agree to indemnify and hold Kenosha Christian Academy harmless from all claims, settlements, judgments and costs, including but not limited to attorneys’ fees, and to reimburse KCA for any expenses whatsoever incurred in connection with an action brought by me or on my behalf as a result of my participation in clubs.

I hereby give my consent to Kenosha Christian Academy to authorize treatment on my behalf in the event of an emergency or illness. I agree to reimburse KCA for any and all costs incurred for such care.

By entering my full name, I attest that this constitutes my legal electronic signature on this form, and I certify I have read and agree to abide by the statements above. 

Full Name

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I understand that submitting this form does not constitute registration for the club. My child will not be considered registered for the club until I recieve a confirmation email from KCA and remit payment to KCA (link for payment will be provided in the confirmation email). *
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