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Elsass Academy Westlake Summer Camp Registration Form 2019 First Child’s Name: _______________________ DOB: ____ /____ /_______ T-Shirt Size (circle one): S (6-8) M (10-12) L (14-16) XL (18-20) youth sizes only Second Child’s Name: _______________________ DOB: ____ /____ /_______ T-Shirt Size (circle one): S (6-8) M (10-12) L (14-16) XL (18-20) youth sizes only **Camp T-Shirts are required to be worn on all Traveling Fieldtrips. A T-Shirt rental fee will be billed to your account for any forgotten shirts the day of your child’s fieldtrip event.** Check dates attending: Westlake Camp (5 – 7 years) _____ Term 1 Mon. June 3 – Fri. June 28 (4 weeks | $1000) _____ Term 2 Mon. July 1 – Fri. July 26 (4 weeks | $1000) _____ Term 3 Mon. July 29 – Fri. August 16 (3 weeks | $750) Switch Camp (8 – 11 years) _____ Term 1 Mon. June 3 – Fri. June 28 (4 weeks | $1,050) _____ Term 2 Mon. July 1 – Fri. July 26 (4 weeks | ($1,050) _____ Term 3 Mon. July 29 – Fri. August 16 (3 weeks | $785) Special Notes: · Registration will begin February 15th for current After School Care/Dragonfly students only and March 1st for the General Public. · Spaces are limited in each camp and are filled on a first-come, first-serve basis. · Spaces cannot be held until a $100 deposit per term per child has been received. This deposit fee is non-refundable & non-transferable and will be applied towards your term balance. · We are unable to prorate for missed days of camp due to illness, vacation, etc. · You will receive a confirmation email in May with additional information about each term of summer camp. · The remainder of term balances are due on the following dates: Term 1 May 1st Term 2 June 3rd Term 3 July 1st · All balances not received by the above dates will result in loss of reserved camp space and deposit fee for that term.

Transcript of 6HFRQG &KLOG¶V 1DPH BBBBBBBBBBBBBBBBBBBBBBB '2% BBBB BBBB BBBBBBB€¦ · 6hfrqg &klog¶v 1dph...

Page 1: 6HFRQG &KLOG¶V 1DPH BBBBBBBBBBBBBBBBBBBBBBB '2% BBBB BBBB BBBBBBB€¦ · 6hfrqg &klog¶v 1dph bbbbbbbbbbbbbbbbbbbbbbb '2% bbbb bbbb bbbbbbb 7 6KLUW 6L]H FLUFOH RQH 6 0 / ;/ \RXWK

Elsass Academy Westlake

Summer Camp Registration Form 2019

First Child’s Name: _______________________ DOB: ____ /____ /_______

T-Shirt Size (circle one): S (6-8) M (10-12) L (14-16) XL (18-20) youth sizes only

Second Child’s Name: _______________________ DOB: ____ /____ /_______

T-Shirt Size (circle one): S (6-8) M (10-12) L (14-16) XL (18-20) youth sizes only

**Camp T-Shirts are required to be worn on all Traveling Fieldtrips. A T-Shirt rental fee will be billed to your account for any forgotten shirts the day of your child’s fieldtrip event.**

Check dates attending:�

Westlake Camp (5 – 7 years) _____ Term 1 Mon. June 3 – Fri. June 28 (4 weeks | $1000)

_____ Term 2 Mon. July 1 – Fri. July 26 (4 weeks | $1000)

_____ Term 3 Mon. July 29 – Fri. August 16 (3 weeks | $750)

Switch Camp (8 – 11 years) _____ Term 1 Mon. June 3 – Fri. June 28 (4 weeks | $1,050)

_____ Term 2 Mon. July 1 – Fri. July 26 (4 weeks | ($1,050)

_____ Term 3 Mon. July 29 – Fri. August 16 (3 weeks | $785)

Special Notes: · Registration will begin February 15th for current After School Care/Dragonfly students only and March 1st

for the General Public. · Spaces are limited in each camp and are filled on a first-come, first-serve basis. · Spaces cannot be held until a $100 deposit per term per child has been received.

This deposit fee is non-refundable & non-transferable and will be applied towards your term balance. · We are unable to prorate for missed days of camp due to illness, vacation, etc. · You will receive a confirmation email in May with additional information about each term of summer

camp.

· The remainder of term balances are due on the following dates: Term 1 May 1st Term 2 June 3rd Term 3 July 1st

· All balances not received by the above dates will result in loss of reserved camp space and deposit fee for that term.

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Elsass Academy Westlake

2019-2020 School Age Program Enrollment Form

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Elsass Academy Westlake

Release Form Student Name:

Please Read and Sign: All precautions will be taken to prevent injuries. Simple first aid will be administered to all minor injuries and parents and/or doctors will be called when necessary. However, in the event that arrangements must be made for emergency medical attention at the time of illness or accident, I hereby authorize Elsass Academy/Crenshaw Athletic Club to take my child to __ Hospital. In return for the use, today and on all future dates, of the property, facilities and services (the “Facilities”) of Elsass Academy/Crenshaw Athletic Club (“Elsass” or “Crenshaws”), the undersigned, for himself/herself, and on behalf of his/her children, heirs, assigns, and legal representatives, hereby expressly agrees to: (1) �ASSUME any and all risks to self and/or my/our children involved in or arising from the use of or

presence upon the facilities, including, without limitation, the risk of bodily injury, property damages or death. I/we are fully aware of and understand the risk of catastrophic injury, paralysis, and even death as well as other damages and losses associated with the participation at Elsass/Crenshaws and/or being on the facilities.

(2) RELEASE Elsass/Crenshaws and all of its successors, assigns, subsidiaries, officers, directors, employees,

and agents from, and agree not to sue them on account of or in connection with any claims, causes of action, injuries, damages, costs or expenses arising out of my/our or my/our child’s use of or presence upon the facilities, including, without limitation, those based on death, bodily injury or property damages; whether or not caused by the negligence or other fault of Elsass/Crenshaws, of its agents, employees, or servants, whether paid or volunteers.

(3) �INDEMNIFY, hold harmless, and defend, at my/our own cost, Elsass/Crenshaws, its agents, employees

and servants from any and all liability, damages, losses, claims, judgments, costs or expenses, including attorney’s fees, which in any way arises from my/our or my/our child’s use of or presence upon the facilities, irrespective or whether such liability, damages, losses, claims, judgments, costs or expenses were actually or allegedly caused wholly or in part through the negligence of Elsass/Crenshaws or any of its agents, employees or servants, whether paid or volunteers.

I have read and understand this assumption of risk, release and indemnification agreement and agree to abide by its terms. I understand a copy of this agreement will be made available for me at my request.

Legal Guardian Signature: _______________________________________ Date: ______________