Summer Camp Registration Form for Jotform

RaRa Foundation Inc.'s Hybrid Summer Camp

Registration Form
Welcome to our Hybrid summer camp for this year 2023!!! We are Excited to be able to provide activities where your child/children can learn various things virtually and enjoy in person field trips. Requirements:1. Computer device (Desktop, laptop, tablet) 2.Network connection 3. Zoom 4. Materials that will be needed for virtual activities will be a pencil and a tablet or paper (optionable) all other materials (will be provided by instructors) 5. Focus and participation 6. Webcam 7. Microphone. 8. You will receive the Zoom link once the Enrollment/Registration Form has been received and reviewed. 9. We will begin at 8:00 A.M Each Morning beginning July 5th 2023. Students may begin signing on at 7:45 A.M. Our Last Instructional day will be August 2nd and a close out Program will be held(Details will be provided) on August 3rd. We will have a picnic on August 4th. Please fill out the form below in order to register and enroll your child/children:
Child's Name
Gender
Student's Date of Birth

MonthDayYear
Date
Student's Age
Nationality (Optional)
Fall School Grade
Student's School
Name of Parent(s)/Guardian(s)
Address
Home Phone Number
Cell Number
Work Number
Note: If any of the above information changes, please notify the RARA office immediately.
While our program is designed for all five weeks, we understand that families may choose to enroll for a shorter amount of time. Please Select ALL the Dates You Child Will Attend

July 5-7 (Wednesday-Friday)July 10-14 (Monday-Friday)July 17-21 (Monday- - Friday)July 24-28 (Monday- Friday)July 31-Aug 4(Monday-Friday)
CURRICULUM:
We offer the following courses as part of our curriculum. Please select any courses your child CANNOT participate in. By leaving this section blank, you give permission for your child to participate in all activities and courses.

Reading/ELAMathBible Study/Character EducationSTEM/STEAMMusicTheatreArts & CraftsFinance for YouthOutdoor Field Trips
EMERGENCY CONTACT INFORMATION
List two emergency contacts other than those listed above:
Name
Relationship
Home Phone
Work Phone
Name
Relationship
Home Phone
Work Phone
Medical Problems/Allergies
EMERGENCY MEDICAL RELEASE
If emergency medical care is necessary and I cannot be reached, I authorize the RaRa Foundation Inc. to act in my behalf in granting permission for my child to receive emergency medical treatment. Parents are responsible for all expenses incurred as the result of medical treatment.
Parent/Legal Guardian Signature

Clear
Date

MonthDayYear
Date
HOLD HARMLESS RELEASE (On-Site Participants Only)

I hereby waive, release, absolve, indemnify, and agree to hold harmless the RaRa Foundation Inc., its directors, officers, organizers, sponsors, supervisory staff, participants, and any other affiliates; for, from, and against all liability because of any bodily injury, or property damage, known or unknown, which may occur or result from the participation of the above-named child in any and all activities. I individually, and as a parent/guardian for my child, have read this release and understand all the terms. I execute it voluntarily and with full knowledge of its significance.
Parent/Legal Guardian Signature

Clear
Date

MonthDayYear
Date
AUTHORIZATION TO PRODUCE AND USE AUDIOVISUAL MATERIALS

I hereby voluntary and without compensation authorize the RaRa Foundation Inc. to produce photographs, movies, videotapes, audiotapes, and Power Point Presentations of the below named student. This authorization is given on the condition that the materials taken or produced will be used for the purpose of community education or program promotion. I understand RaRa Foundation Inc Association, Inc. and its employees will not use these materials for compensation. I understand that this grant of permission shall only be revoked by a written instrument delivered to the Executive Director of the RaRa Foundation Inc. This consent shall remain in effect,unless revoked.
Name of Student
Name of Parent/Legal Guardian
Date

MonthDayYear
Date
Parent/Legal Guardian Signature

Clear
The parent/guardian should supervise the child/children for the virtual activities. For children below 13 years old, the parent/guardian will be responsible for handling, maintaining, and supervising their accounts. Most video conferencing may be recorded so by signing this form, you agree for the child/children to be recorded for archive and training matters. Please avoid absences because the slot is already resolved for the student. The video conferencing app that will be used is via Zoom. If an issue occurs, the next app to use will be Google Meet. Kindly make sure that all requirements are available to fully enjoy the virtual summer camp. Student should have a pencil and paper available. Student will not be allowed to participate if found taking part in any form of cyber bullying. All such will be discussed during first day of Summer Camp during morning opening.
Date

MonthDayYear
Date
Signature

Clear
Code Of Conduct

Positive attitudes keep Tutoring fun. Below are some guidelines participants are expected to follow.

Please review these expectations with your child/children.

General Rules for Everyone:

Respect Yourself, the RARA Staff, Other Students, and Their Property.

Follow the Instructions the First Time

Play Fairly and Be Honest

Cheer On the Efforts of Others and Be Positive

Avoid Inappropriate Language

Onsite Rules:

Eat and Drink in Designated Areas

Respect the Facility, Grounds, and Equipment

Clean Up After Yourself

Running is Only Allowed on the Outside

No Tobacco, drugs, alcohol, and weapons are prohibited
Child's Signature

Clear
Date

MonthDayYear
Date
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
BULLYING/HARASSMENT/FIGHTING POLICY

Bullying/harassment/fighting has no place at the RaRa Foundation Inc. Tutoring. Bullying/harassment/fighting means more than beating up or pushing people around. Physical assaults (touching in angry ways) Violation of this policy includes:Threats ("Better watch your back", "I'm gonna hurt you", "We're gonna get you", etc. Harassment (always bothering someone) -Name-calling -Racial slurs -Intimidation -Sexual harassment - physical or verbal -Spreading rumors-Extortion -Foul language -Taunting -Making insulting remarks about another student's family members - Using the internet to harass, threaten, verbally abuse, intimidate, or spread rumors.

Violation of the intent of this policy by a participant of the RaRa Foundation Inc will not be tolerated. Review of the policy serves as your WARNING. If you are found to be in violation of this policy, you will be suspended from this program. The enforcement of this policy and any judgment on the punishment of a student for violation of this policy will be the decision of the RARA Program Coordinator or Assistant Coordinator or both and is not subject to a hearing or appeal.
Child's Signature

Clear
Date

MonthDayYear
Date
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
CHECK-OUT AUTHORIZATION FORM
Student's Name
The following individuals are AUTHORIZED to check-out the above-named student from all RARA activities. Note: Add additional names if needed.
1. Name
Relationship
Name
Relationship
Name
Relationship
Please note if anyone is PROHIBITED from contacting or checking-out the student. Specify the individual(s) below:
Name
Relationship
Name
Relationship
Will You Need Payment Assistance?

Yes, Please sign, date and submit.No, Please indicate payment type below.
You may Pay each week or all at once, whichever works best for you! You may Cash App us by using $RaRaFoundation, please place the words "For Summer Camp in the comments of the Cash App. You may also pay by going to www.RaRaFoundation.Org and selecting Summer Camp Payment via Pay Pal or you may use Zelle and send to RaRaFoundationinc@gmail.com. Finally you may wish to have us invoice you. Please use the blank below and type in how you wish to send payments. For example if it is Cash App simply type in Cash App, if Zelle then Zelle, if you will be paying through our website type in Website, and finally if you wish to be invoiced simply type in invoice.
Payment Type
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

CURRICULUM:

EMERGENCY CONTACT INFORMATION

EMERGENCY MEDICAL RELEASE

CHECK-OUT AUTHORIZATION FORM