First Parent/Guardian
Second Parent/Guardian
Emergency Contact Information
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.
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 Summer Institute or students.
For-Credit Courses:
Honors Algebra II / Trigonometry
Dates: June 27 - August 5Time: 12:30 to 4:45 p.m.Instructor: GSB Mathematics DepartmentCost: $2,000(No classes on July 4th)
Academic Enrichment Courses:
Algebra II / TrigonometryPreview
Dates: August 1-5Time: 1:00 - 2:00 p.m.Instructor: Fred Corona, GSB MathematicsCost: $250
Dates: August 8-12Time: 1:00 - 3:00 p.m.Instructor:Margery Schiesswohl, GSB 9th Grade DeanCost: $500
Dates: WednesdaysTime: 7:00 - 8:30 p.m.Instructor: Brendan Flanagan, GSB EnglishCost: $30.00 per session
July 6th: The Great Gatsby
July 13th: Lord of the Flies
July 27th: Animal Farm
August 3rd: The Giver
August 10th:Their Eyes Were Watching God
August 17th: The Outsiders
Deposits & Refunds: Summer Institute deposits will be charged at registration with full balances due at the start of the Student’s 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 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 student'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.