If yes to the above question, please identify? blanks .
If yes to the above question, please indicate which? blanks .
If yes to the above question, please describe? blanks .
If yes to the above question, please describe/explain? blanks .
What is the name of your family physician? blanks field.
Other relatives and/or neighbors who will assume temporary care of your child if you cannot be reached.1. blanks (Name & Phone)2. Type a label (Name & Phone)
In case of an accident or serious illness and that Easton Banks Learning & Life Center is not able to reach me, I hereby authorize program staff to call the physician indicated on the registration form and follow his/her instructions, as well as contacting the "temporary care" person(s) listed above. I also understand that in the event of an emergency, the Easton Banks Learning & Life Center will make its first call to 911.
In the event that I am unable to pick up my child(ren) at the scheduled time on the days that camp participants meet in person, I grant permission to the following persons. I further understand that staff of Easton Banks Learning & Life Center will charge $5.00 per minute. I also understand that this payment is due at the time of pick-up and should be made payable to the staff member who had to wait for the camp participant's parent/guardian.
For my child to have the ultimate experience attending the STEAM Summer Youth Camp, I acknowledge that I will be obligated to pay Easton Banks Learning & Life Center, Inc. a weekly fee of $85. I, further understand that fees are due the Friday before the next week of camp activities and no later than the Monday of the week of scheduled activities. If I am unable to fulfill this obligation I will inform camp administration immediately by calling 470-778-7189 or emailing info.bankslearning@yahoo.com.
I acknowledge and adhere to the payment policy and confirm by my signature below.
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