2022 Summer Camp

Camper Name *

First Name Last Name

Camp Options: *

Camper Name

First Name Last Name

Camp Options:

Camper Name

First Name Last Name

Camp Options:

Camper Name

First Name Last Name

Camp Options:

Parent Name *

First Name Last Name

Parent Email *

example@example.com

Address *

Street Address

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City State / Province

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Phone Number *

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Emergency Contact *

First Name Last Name

Emergency Contact Phone Number *

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I understand every effort will be made to contact a parent or emergency contact. If we cannot be reached, I give my consent for the emergency room physician to treat my child. **Add signature *

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Art Camp (Ages 5-13): $200 (includes one apron per camper) (See examples of paintings here: https://www.enrichmentacademy.net/camp-descriptions.html)

June 13-17, 2022 9:0am-11:00am

Lil' Baker Camp (Ages 5-13): $175 (includes one apron per camper)

June 13-17, 2022 11:30am-2:30pm

Science Summer Camp (Ages 5-13): $250 (includes one t-shirt per camper)

June 20-24, 2022 9:00am - 2:00pm

Camper 1: T-Shirt Size (Science Camp Only)

Camper 2: T-Shirt Size (Science Camp Only)

Camper 3: T-Shirt Size (Science Camp Only)

Extra T-Shirts-$15 Each-specify quantity and sizes

Discounts:

2 siblings: $30 off total

2 camp sign up (same camper): $30 off total

3+ Siblings: $75 off total

3 camp sign up (same camper): $75 off total

By registering with Enrichment Academy, we are committing to provide your child(ren) with a high quality educational experience. By signing this commitment letter, you agree to be responsible for the payment assigned to the camp your child(ren) is registered for. Withdrawal a week (7 days or less) before registered camp does not void the financial obligation. NO REFUND WILL BE ISSUED IF WITHDRAWED A WEEK (7 days or less) BEFORE REGISTERED CAMP.

A $50 non-refundable deposit is included in the camp prices. A refund minus the non-refundable deposit will be issued if camp registration is withdrawn more than a week (8+ days) before registered camp date.

I understand the above financial obligation and agree to provide payment in full or pay a drop fee in the event of camp discontinuation.

Parent's Signature *

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YOUTH LIABILITY RELEASE AND WAIVER

In consideration of being allowed to participate in any way in Enrichment Academy’s related events and activities, the undersigned:
1. Agree that the parent(s) and/or legal guardian(s) of the participant should inspect the facilities and equipment to be used, and if the parent or guardian believes anything is unsafe, he or she should immediately advise supervisor of such condition(s) and refuse to participate
2. Acknowledge and fully understand that each member/participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence but the action, inaction, and negligence of others, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
3. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death
4. Release, waive, discharge and covenant not to sue Enrichment Academy its affiliated clubs, their respective administrators, directors, and other employees of the organization, other members/participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors or premises used to conduct the event, all of which are hereinafter referred to as “releases”, from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise.

Enrichment Academy does hold an active liability insurance policy.

I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY *

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PHOTO & SOCIAL MEDIA RELEASE FORM
We photograph and video many of our classroom activities and love to share them with our school community. Please tell me whether or not you permit the following to be done with pictures/videos of your child.

I give/withhold my permission for classroom photographs and/or videos of my child to be shared in the following ways: *

Posted to Enrichment Academy's Facebook Page No. Permission not given for Facebook Posts Posted to Enrichment Academy's website No. Permission not given for website posts

Parent's Signature *

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COVID-19 WAIVER & ALLERGY INFO

I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.

I further acknowledge that Enrichment Academy LLC has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

I further acknowledge that Enrichment Academy LLC can not guarantee that the student will not become infected with the Coronavirus/Covid-19.

I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, and other clients and their families.

I voluntarily seek services provided by Enrichment Academy LLC and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19.

Enrichment Academy has a NUT FREE Policy. We have several students who have a severe food allergy to peanuts/nuts. It is important that there is strict avoidance to this food in order to prevent a life-threatening allergic reaction. We are asking for your help to provide these students with a safe tutorial environment.

Parent's Signature *

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Please inform us of any allergies or medical conditions your child may have.

Total Due: *

USD Description

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Enrichment Academy Summer Camps