Schools In Session Summer Camp Registration Form

SCHOOLS IN SESSION SUMMER REGISTRATION
Welcome to Schools In Session Summer Programs 2022! We are excited to welcome your child back to our summer programs. Our committment to success and nothing less is what we strive to do each and every day at SIS! Your child will not be fully registered until registration and fee is complete. Upon completion summer program information will be emailed regarding summer enrollment.

Our health and safety plan will include a variety of measures:

Limited class sizes to ensure social distancing
Mask requirements for everyone
Procedures for drop-off and pick-up

We look forward to a fun and safe learning experience this summer!
STUDENT INFORMATION
Child Name *

First Name Last Name
Grade Level Completed in 2021-22 School Year *
SIS Enrollment *
Gender *

Male Female
Age *
Date of Birth *

Month Day Year
Unfortunately we are unable to accommodate students with an IEP? Does your child have an IEP? *

Yes No
SIS Enrollment (sibling)
Child Name (sibling)

First Name Last Name
Date of Birth (Sibling)

Month Day Year
Age (sibling)
Grade Level Completed in 2021-22 (sibling)
Unfortunately we are unable to accommodate students with an IEP? Does your child have an IEP? *

Yes No
Gender (sibling)

Male Female
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
PARENT/GUARDIAN INFORMATION
Mother/Guardian *

First Name Last Name
Cell Number *

Area Code Phone Number
Email *
example@example.com
Father *

First Name Last Name
Cell Number *

Area Code Phone Number
Home Number

Area Code Phone Number
E-mail *
EMERGENCY CONTACT INFORMATION
Emergency Contact's Name *

First Name Last Name
Relationship *
Phone Number *

Area Code Phone Number
Alt. Phone Number

Area Code Phone Number
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe. *
Is the student prescribed any medications i.e inhaler or epipen? If yes, please explain any instructions. *
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Schools In Session during the selected camp. In exchange for the acceptance of said child’s candidacy by Schools In Session. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Schools In Session, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Schools In Session. Including all affiliates, all participants, sponsoring agencies, advertisers if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Lastly, I am aware that Schools In Session has been granted permission to operate under an exemption from current Bright from the Start Licensing for Summer Camps, meaning we are not held to the same restrictions as a licensed day care facility.
By signing your name, you consent to use your electronic signature to sign any document or communication and to receive electronic delivery of any document or communication. You understand that your electronic signature is legally binding, just as if you had signed a paper document.
Name *

First Name Last Name
PLEASE NOTE: BY SUBMITTING THIS APPLICATION IT DOES NOT GUARANTEE A SPOT FOR YOUR CHILD. WE MUST RECEIVE YOUR $100.00 DEPOSIT TO GUARANTEE A SPOT. PLEASE CHOOSE HOW YOU WILL MAKE YOUR DEPOSIT. CAMP FEES ARE NON-REFUNDABLE AND NON-TRANSFERABLE
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K-5th Grade Registration $ 100.00
Use this registration for grades K-5th grade Sparks Summer Camp

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Grades 6th-8th Grade Registration $ 100.00
Use this registration for grade 6-8th grade Sparks Academic Camp

Quantity

Total $ 0.00
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SCHOOLS IN SESSION SUMMER REGISTRATION

STUDENT INFORMATION

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT INFORMATION