RaRa Foundation Inc.'s Hybrid Summer Camp Registration Form

RaRa Foundation Inc.'s Hybrid Summer Camp Registration Form
Welcome to our Hybrid summer camp for this year 2025!!! We are Excited to be able to provide activities where your child/children can learn various things virtually or onsite and enjoy in person field trips. Please fill out the form below in order to register and enroll your child/children:
Parent/Guardian Name

First NameLast Name
Parent/Guardian Address and Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Email
example@example.com
Student's Name

First NameLast Name
Student's Age
Date of Birth

MonthDayYear
Date
Grade Level
School
This is a 5-week summer camp program, please choose the dates you know that your child will not be in attendance:

Monday thru Thurs. June 30-July 3Monday thru Friday July 7-11Monday thru Friday July 14-18Monday thru Friday July 21-25Monday thru Friday July 28-August 1
We offer the following courses as part of our curriculum. Please select any course your child cannot participate in.

Reading/ ELAMathBible Study/SEL/Character EducationSTEM/STEAMMusicTheaterArts & CraftsFinance for Youth4 of 6 Possible Outdoor Field Trips(NASA ,Houston Zoo, Children's Museum, Conroe's Incredible Pizza, Discovery Camp, Houston Aquarium/Neither Guaranteed/ Depends Upon Available Donations)Cooking/SewingCreating A PodcastDanceN/A
Emergency Contact Information:

Please list 2 Emergency Contacts Below:
First Name: Last Name: Phone Number: Relationship: First Name Last Name Phone Number: Relationship:
EMERGENCY MEDICAL RELEASE
If emergency medical care is necessary and I cannot be reached, I authorize the RaRa Foundation Inc. to act in my behalf in granting permission for my child to receive emergency medical treatment. Parents are responsible for all expenses incurred as the result of medical treatment. Please Sign below agreeing to this Emergency Medical Release Statement.
Signature

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Please list any Medical Problems and/or Allergies your child may have below.
HOLD HARMLESS RELEASE (On-Site Participants)
I hereby waive, release, absolve, indemnify, and agree to hold harmless the RaRa Foundation Inc., its directors, officers, organizers, sponsors, supervisory staff, participants, and any other affiliates; for, from, and against all liability because of any bodily injury, or property damage, known or unknown, which may occur or result from the participation of the above-named child in any and all activities. I individually, and as a parent/guardian for my child, have read this release and understand all the terms. I execute it voluntarily and with full knowledge of its significance. Please sign below agreeing to HOLD HARMLESS RELEASE STATEMENT.
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AUTHORIZATION TO PRODUCE AND USE AUDIOVISUAL MATERIALS
I hereby voluntary and without compensation authorize the RaRa Foundation Inc. to produce photographs, movies, videotapes, audiotapes, and Power Point Presentations of the below named student. This authorization is given on the condition that the materials taken or produced will be used for the purpose of community education or program promotion. I understand RaRa Foundation Inc Association, Inc. and its employees will not use these materials for compensation.
I understand that this grant of permission shall only be revoked by a written instrument delivered to the Executive Director of the RaRa Foundation Inc. This consent shall remain in effect, unless revoked.
Please Sign Below Agreeing to Authorization to produce and use audivisual materials for use stated above only.
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CODE OF CONDUCT
Positive attitudes keep Tutoring and Summer Camp fun. Below are some guidelines participants are expected to follow.
Please review these expectations with your child/children.
General Rules for Everyone:
• Respect Yourself, the RARA Staff, Other
Students, and Their Property.
• Follow the Instructions the First Time
• Play Fairly and Be Honest
• Cheer On the Efforts of Others and Be
Positive
• Avoid Inappropriate Language
On-Site Rules:
• Eat and Drink in Designated Areas
• Respect the Facility, Grounds, and
Equipment
• Clean Up After Yourself
• Running is Only Allowed in Outside
Areas
• Tobacco, drugs, alcohol, and weapons
are prohibited
Both Student and Parent will sign Below Agreeing to Code Of Conduct.
Child Signature

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Parent Signature

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BULLYING/HARASSMENT/FIGHTING POLICY
Bullying/harassment/fighting has no place at the RaRa Foundation Inc. Tutoring.
Bullying/harassment/ fighting means more than beating up or pushing people around.
Violation of this policy includes: • Physical assaults (touching in angry ways) • Threats (“Better watch your back”, “I’m gonna hurt you”, “We’re gonna get you”, etc.) • Harassment (always bothering someone) • Name-calling • Racial slurs • Intimidation • Sexual harassment – physical or verbal • Spreading rumors • Extortion • Foul language • Taunting • Making insulting remarks about another student’s family members • Using the internet to harass, threaten, verbally abuse, intimidate, or spread rumors.
Violation of the intent of this policy by a participant of the RaRa Foundation Inc will not be tolerated. Review of the policy serves as your WARNING. If you are found to be in violation of this policy, you will be suspended from this program. The enforcement of this policy and any judgment on the punishment of a student for violation of this policy will be the decision of the RARA Program Coordinator or Assistant Coordinator or both and is not subject to a hearing or appeal. Please Sign Below in Agreement to Bullying/Harassment and Fighting Policy.
Parent/Guardian Signature

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Will You Need Payment Assistance?

Yes, then Please call 713 204 3764 and request A Scholarship Form. Please skip the next question.No
You may Pay each week or all at once, whichever works best for you! You may Cash App us by Using $RaRaFoundation, please place the words For Summer Camp in the comments of the Cash App. You may also pay by going to www.RaRaFoundation.Org and selecting Summer Camp Payment via Pay Pal or you may use Zelle and send to RaRaFoundationInc@gmail.com. Finally you may wish to have us invoice you. Please use the blank below and place how you wish to send payments. For example, if it is Cash App simply type in Cash App, if Zelle then Zelle, if through our website type in Website, and finally if you wish to be invoiced simply type in invoice.
Terms and Conditions
The parent/guardian should supervise the child/children if needed for the virtual activities. For children below 13 years old, the parent/guardian will be responsible for handling, maintaining, and supervising their Zoom accounts. Most video conferencing May be recorded so by signing this form, you agree for the child/children to be recorded for archive, training, matters only. Please avoid absences because the slot is reserved for the student. The video conferencing app that will be used is via Zoom. If an issue occurs, the next app to use will be Google Meet. Kindly make sure that all requirements are available to fully enjoy the virtual summer camp. Student should have a pencil and paper available.Student will not be allowed to participate if found taking part in any form of cyber bullying. All such will be discussed during first day of Summer Camp during morning opening. Amounts are to be paid by each Friday for the upcoming week. No student is turned away. If assistance is needed, please make sure parent checks box marked "Needs Assistance" and fills out scholarship form. Proof of income will be asked for when assistance is requested.
Parent/Guardian Signature

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Date Signed

MonthDayYear
Date
Should be Empty:

RaRa Foundation Inc.'s Hybrid Summer Camp Registration Form

Emergency Contact Information:

Terms and Conditions