Education Camp Enrollment Form

EDUCATION CAMP ENROLLMENT FORM

Camp Name:   Camp Location:

Session Selection

Select session(s) enrolling in (check all that apply):

Week 1 — Dates: Week 2 — Dates: Week 3 — Dates:

Student Information

Parent / Guardian Information

Emergency Contact (Other Than Parent)

Medical Information & Authorization

I authorize camp staff to administer the medications and follow instructions provided above and to consult the physician named if necessary: Yes

Transportation & Field Trips

I authorize my child to be transported by camp-authorized drivers for field trips, emergency transport, and supervised off-site activities. Mode of transport (check all that apply):

Bus Private vehicle (staff) Public transit/walking

Photo & Media Release

I grant the camp the right to photograph and record my child for educational, promotional, and archival purposes. I understand that images may be used in print and electronic media and waive rights to compensation.

Consent Decline

Tuition, Payment & Refund Policy

Deposit secures enrollment. Remaining balance is due according to the selected payment plan. All tuition payments are non-transferable. Refunds will be issued only as described below.

Cancellation and refund schedule: cancellations made more than 30 days prior to session start will receive refund of tuition less deposit; cancellations within 30 days are subject to partial or no refund at the discretion of camp administration, except as required by law. Requests for cancellation must be submitted in writing to camp administration and are effective on receipt.

Behavior, Discipline & Code of Conduct

The student is expected to adhere to all camp rules and staff directions. Serious misconduct, endangering behavior, or refusal to follow instruction may result in dismissal without refund. The undersigned accepts responsibility for transportation and any fees associated with early dismissal.

I acknowledge and agree to the camp code of conduct and disciplinary policy.

Liability Waiver & Release

In consideration of my child's participation in camp activities, I, on behalf of myself, my child, and my heirs, release and hold harmless the camp, its directors, employees, volunteers, and agents from any liability for injury, death, or loss arising from participation, except to the extent caused by the camp's gross negligence or willful misconduct. I understand that participation involves inherent risks and I assume responsibility for those risks.

I further agree to indemnify and defend the camp against claims, demands, or causes of action arising from my child's negligent or intentional acts during camp participation.

Medical Treatment Authorization

If I cannot be reached in an emergency, I authorize camp staff to obtain medical treatment for my child, including first aid, emergency medical transport, and admission to a hospital for treatment. I authorize the release of medical information to treating medical personnel as necessary. I understand I am responsible for any costs not covered by insurance.

Medical limitations, special instructions, or other information not previously provided:

Acknowledgment & Certification

By signing below, I certify that the information provided on this form is true and complete to the best of my knowledge; I have disclosed known allergies, medical conditions, and medications. I acknowledge receipt of the camp policies including tuition and refund terms and consent to the medical and transportation authorizations set forth above.

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