Purpose of the Day or Summer Camp Enrollment Form

This form is used to enroll a child in the school’s day or summer camps. It collects important information about the child and their participation schedule, as well as emergency contacts and any special needs. Parents or guardians must review and complete this form to ensure their child’s safe and successful participation in the program.

Program Enrollment Details.

Summer Camp Week 4 Superhero Academy - June 30 - July 3

Summer Camp Week 5 Famous Landmarks - July 7 - July 11

Summer Camp Week 6 Rainforest Explorers - July 14 - July 18

Summer Camp Week 7 All Star Sports - July 21 - July 25

Summer Camp Week 8 Hot Wheels & Racing- July 28 - August 1

Summer Camp Week 9 Lego Builders - August 4 - August 8

Please list all allergies or medical conditions. *

Please fill out student information below.

Student First Name: *

Student Last Name: *

Grade:

List all individuals authorized to pick up your child from the program(s).

Full Name: *

Phone Number: *

Relationship to Student: *

Full Name:

Phone Number:

Relationship to Student:

Full Name:

Phone Number:

Relationship to Student:

Please provide at least one emergency contact who can be reached if you are unavailable.

Emergency Contact Full Name #1: *

Emergency Contact Phone Number #1: *

Emergency Contact Email #1: *

Emergency Contact Full Name #2:

Emergency Contact Phone Number #2:

Emergency Contact Email #2:

School Waiver and Release of Liability Form -Sample Waiver

I hereby give my permission for my child(ren) to participate in InfinityInclusion Microschool Summer Camp. Participation in any program which involves physical activity exposes the student to certain risks and dangers. Accidents and injuries are always a possibility, and it is impossible to foresee and protect the student from all conceivable dangers. I hereby affirm that my child(ren) has/have no conditions that would make it unsafe for him/her/them to participate in the School Program.

By signing this Waiver and Release of Liability, with full appreciation of the risk involved, on my own behalf and on behalf of my child(ren), I hereby voluntarily release and forever discharge the School, employees and contractors from any and all legal or financial responsibility for any personal injury, disability, illness, damage, medical expense or death, arising from or related to my child(ren)’s participation in the Program. I agree, for myself and my child(ren), not to make any type of legal or equitable claim on the School, or any of its trustees, officers, employees, agents, insurers or contractors with respect to any injury I or my child(ren) may suffer, whether or not it arises through the negligence, omission, default or other action of anyone affiliated with the School, including other students. I further agree that if any such claim is made, I will indemnify and defend the School with respect to any such claim, injury or damage.

I have read the waiver and limited liability release.

By signing below, I verify that I am the parent or legal guardian of the child named above and that I have read, understood, and agree to the terms of this Before/After School Program Enrollment Form.

Use the space above to sign your name