Scattered Seeds at New Life Glenside (Summer 2022)

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Student Name* This field is required.
First Name
Last Name
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Grade* This field is required.Grade student will be entering in the 2022-2023 School Year.
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Choose A Camp* This field is required.
Artiful Early Elementary Camp (August 1-5), Grades 1-3
Artiful Camp (August 1-5), Grades 4-10
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Address* This field is required.
Street Address
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Parent / Guardian Name* This field is required.
First Name
Last Name
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Parent / Guardian E-Mail* This field is required.
example@example.com
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Parent / Guardian Mobile Number* This field is required.
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Emergency Contact Name* This field is required.
First Name
Last Name
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Emergency Contact Phone Number* This field is required.
10
Medical / AllergiesDescribe any medical conditions (allergies, asthma, etc.), if medications need to be taken at camp and any instructions
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Ok
11
Medical & Liability ReleaseAs the parent / guardian of the child named above, I give permission for him/her to fully participate in all activities in the Scattered Seeds / New Life Presbyterian Church of Glenside Artiful Camp. I recognize that the conditions and circumstances encountered during travel to and participation in activities may cause my child to be exposed to certain risks to health and personal property. I am allowing my child to participate in the activities with awareness of such risks. Further, I release New Life Presbyterian Church, Scattered Seeds, and its employees and agents from any claim of any kind whatsoever. In the event of a medical emergency, I give permission to New Life Presbyterian Church of Glenside, Scattered Seeds, its authorized employees and agents, to take my child to a doctor or hospital, and I authorize medical treatment and surgical procedures to be provided to my child, as necessary. I will be notified at the earliest possible opportunity of any medical treatments. I will assume responsibility for all medical bills incurred. In addition, if my child is required to return home for medical or disciplinary reasons, or otherwise, I will assume responsibility for any transportation costs, as well as for any property damages and expenses which may be incurred by my child while he/she is participating in activities sponsored by New Life Presbyterian Church of Glenside and Scattered Seeds.
ClearSignature of consent
12
Photo Release AuthorizationI grant permission for Scattered Seeds, Valley Christian School, and Huntingdon Valley Presbyterian Church to publish pictures and videos of my child for public publicity.
ClearSignature of consent
13
Payment* This field is required.Online Cost: $175 + $7 (Processing Fee)
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ORDER SUMMARY
Total costUSD
Artiful Early Elementary (August 1-5, 9AM - 3PM)For grades 1-3. Join us as we explore art together! We will use a variety of art mediums in both individual andcollaborative projects which may include drama, music, fine art, creative movement, and literacy-inspired art. | Online Cost: $175 + $7 (Processing Fee)
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Artiful Camp (August 1-5, 9AM - 3PM)For grades 4-10. Join us as we explore art together! We will use a variety of art mediums in both individual and collaborative projects which may include drama, music, fine art, creative movement, and literacy-inspired art. | Online Cost: $175 + $7 (Processing Fee)
$175.00+Edit
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Total cost $0.00
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