GSB Summer Camp Detailed Registration Form 2022

Household Information
First Parent/Guardian
Name *

First Name Last Name
Cell Phone Number *
E-mail Address *
example@example.com
Second Parent/Guardian
Name

First Name Last Name
Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Emergency Contact Information
Emergency Contact #1 *

First Name Last Name
Relationship *
Primary Phone Number *
Alternative Phone Number
Please enter a valid phone number.
Emergency Contact #2

First Name Last Name
Relationship
Primary Phone Number
Alternative Phone Number
Please enter a valid phone number.
Emergency Contact #3

First Name Last Name
Relationship
Primary Phone Number
Alternative Phone Number
Please enter a valid phone number.

Health History Information
Are you currently enrolled at Gill St. Bernard's School? *

Yes No
Has your child's Magnus Health information been updated for the 2022-23 school year? *

Yes No
Camper Medical Forms *

Please upload pertinent camper medical information including primary physician information, allergies, medication, and other healthy history information. Multiple files are allowed. Click here to download our health history form.
Cancel of
Don't have a current medical form? Click here to download.
Are there any current or past medical conditions that Gill St. Bernard's Summer Camp should be made aware of? *

Yes No
Please explain prior conditions or health history that you feel is important for us to know. *
Please list any other medical information the camp should have about your child.
Is there anything you would like to discuss with the camp medical staff?

Emergency Waiver
To the best of my knowledge this Health History is correct and complete. The camper has permission to participate in all camp activities unless otherwise noted on this form.

I hereby give permission to GSB Camps to provide, seek, and consent to routine medical health care, administration of prescribed medications, and emergency treatment for my child as may be necessary. This includes, but is not limited to: x-rays, routine tests and treatment, and/or hospitalization. I give permission to GSB Camps to provide transportation required for treatment. I understand that all medical bills for services to my child rendered by anyone other than the GSB Camps staff are my responsibility. I agree to release any records necessary for treatment, billing, or insurance purposes.

It is my intention that the camp be treated as acting in loco parentis for my child. If I cannot be reached in the event of an emergency, I grant permission to GSB Camps to use the physician they have selected to secure treatment, including hospitalization.
Signature *

Clear

Terms & Conditions
Gill St. Bernard's reserves the right to dismiss or suspend any student whose conditon or behavior is deemed unsatisfactory or detrimental to the best interest of camp or students.
Parents hereby grant permission to use bug repellent or sunscreen if necessary during the camp day. *

I accept I decline
Photo & Video Release
I hereby grant permission to use photography and video footage taken at Gill St. Bernard's Summer Camp for promotion or display. *

I accept I decline
Signature *

Clear

GSB Summer Camp Information

Rising Grade	Camp	Fees*
Preschool- Kindergarten	Kindercamp - Full Day	$600 per week
Preschool-Kindergarten	Kindercamp - Half Day	$375 per week
1-6	Day Camp	$650 per week
7-8	Travel Camp	$750 per week**
	GSB Summer Institute	Course fees vary
	GSB Summer Knights Sports Camps	Course fees vary
***	Transportation	$110 per week
	Before Care	$75 per week
	After Care	$90 per week
K-12	Piano or Voice Lesssons	$200 for four 30-minute lessons

* Week 2 will be prorated to account for the July 4th Holiday.

** Additional costs may occur for Travel Camp based on trips scheduled

*** Central transportation requires a minimum number of campers.

Discounts:

$200.00 off with minimum of two weeks. Camper must be registered by March 11, 2022
10% GSB discount - For students enrolled in the 2022-23 academic school year.

Deposits & Refunds: Camp deposits will be charged at registration with full balances due at the start of the Campers’ first registered week. Deposits are refundable until June 1, 2022, except for a $50 processing fee. After June 1st, refunds will be at the discretion of the CFO, payable at the end of the camp season. There are no refunds due to withdrawals or emergency closings.

GSB Camps and GSB Summer Institute for Credit Courses require a minimum $525 deposit upon registration which includes a registration fee. Full balance is due at the start of the camper's first registered week. All other summer programs are to be paid in full upon registration.

Make checks payable to Gill St. Bernard's School. Credit cards accepted: Visa, Mastercard, Discover, and American Express. Checks returned for insufficient funds will be charged a processing fee.

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Gill St. Bernard's Summer Camp Registration 2022

Camper Information

Please submit a form for each camper.

Household Information

Health History Information

Emergency Waiver

Terms & Conditions

Photo & Video Release

GSB Summer Camp Information

Pressing "Submit Form" multiple times may result in duplicate charges. Please wait.