Summer Camp Registration Form

Hanlin Summer Camp Registration

A wonderful summer time begin with us...
-Hanlin Summer Camp will run from June 13, 2022 - August 19, 2022

-Camp hours are from 8:30 am - 6:00 pm

-Campers must be aged 4 and up to 5th grade.
(**all campers aged 5 and up must be fully vaccinated. Their vaccination card can be uploaded below)

-Each weekly session is $390.00.

-Camp fees must be paid in full upon registration.

-Cancellations must be made before the start of summer camp. If you need to cancel after camp has started, a fee will be applied ($150) for each cancelled week

-If your child is out due to COVID, we can offer credit towards a new week, but we will not offer camp fee refunds

-Daily drop ins will not be accepted

-Hot Lunch is offered this summer, $7/day.

Camp Location: 690 El Camino Real, Belmont, 94002
Camper's Name *

First Name Last Name
Birth Date *

Month Day Year
Age *
Gender *

Male Female
Camper's Name (Sibling)

First Name Last Name
Birth Date (Sibling)

Month Day Year
Age (Sibling)
Gender (sibling)

Male Female
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
PLEASE SELECT THE WEEKS YOU WOULD LIKE TO JOIN US FOR CAMP:
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Session 1: 6/13-6/17 $ 390.00
Arts and Crafts

Session 2: 6/20-6/24 $ 390.00
Pottery & Clay

Session 3: 6/27-7/01 $ 390.00
Sports

Session 4: 7/05-7/08 (no school on July 4th) $ 315.00
Cooking

Session 5: 7/11-7/15 $ 390.00
Music

Session 6: 7/18-7/22 $ 390.00
Gardening

Session 7: 7/25-7/29 $ 390.00
Legos

Session 8: 8/01-8/05 $ 390.00
Coding & Robotics

Session 9: 8/08-8/12 $ 390.00
3-D Printing

Session 10 8/15-8/19 $ 390.00
Art & Craft week

Session 11 8/22-8/26 $ 390.00
Clay Week

Session 12 8/29-9/2 $ 390.00
Gardening

Single Day 6/10 $ 90.00

Single Day 8/15 $ 90.00

Single Day 8/16 $ 90.00

Single Day 8/22 $ 90.00

Single Day 8/23 $ 90.00

Total $ 0.00
Parent/Guardian Information
Mother's Name *

First Name Last Name
Father's Name *

First Name Last Name
Home Phone Number

Area Code Phone Number
Mother's Cell Phone Number *

Area Code Phone Number
Father's Cell Phone Number *

Area Code Phone Number
E-mail 1 *
E-mail 2 *
example@example.com
Emergency Information
Emergency Contact's Name *

First Name Last Name
Relationship
Phone Number *

Area Code Phone Number
Alt. Phone Number

Area Code Phone Number
For campers aged 5 and older, please upload a copy of their COVID-19 vaccination card

Browse Files

Cancel of
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe. *
Is the camper 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 Hanlin Academy Inc. during the selected camp. In exchange for the acceptance of said child’s candidacy by Hanlin Academy Inc., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Hanlin Academy Inc., 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 Hanlin Academy Inc., 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.
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Name *

First Name Last Name
PLEASE NOTE: BY SUBMITTING THIS APPLICATION IT DOES NOT GUARANTEE A SPOT FOR YOUR CHILD. A CONFIRMATION EMAIL WILL SEND TO YOU ONCE YOU PAID OUR INVOICE. CAMP FEES ARE NON-REFUNDABLE AND NON-TRANSFERABLE.
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Hanlin Summer Camp Registration