Outdoor Camp 2025 Mi Escuelita en Español Enrollment Form

Camper A*

First nameLast name

Birth Date*

MaleFemale

Camper B

First nameLast name

Birth Date

MaleFemale

Camper C

First nameLast name

Birth Date

MaleFemale

Please notify us of any allergies or health conditions

Address*

Street Address 1

Street Address 2

CityState / Province

Postal / Zip Code

Parent information *

NameLast Name

Email*

example@example.com

Mobile Number*

Format: (000) 000-0000.

Work Number

Format: (000) 000-0000.

Please indicate the date(s) you are signing up for (one-day camp)

Please indicate the dates your child will stay in aftercare

Checks payable to Ines Portugal. Send to 147 Silliman St, San Francisco, CA 94134.Venmo @Ines-Portugal-1Cost $140 per day from 9 am to 2 pmCost $650 per weekAftercare per hour is $27 per child/per hour from 2pm to 4pm (2 children as minimum). In case is only 1 child enrollment for aftercare the price is $35 per hour. This amount will not be shown in your total payment and the camp director will be in contact with you to arrange this payment separately.

Outdoor Camp- Drop Off and Pick up Location is in Glen Canyon: Passenger Drop off by Glen Park Rec Center, 70 Elk Street.

Camp locations are subject to San Francisco weather conditions. Any change of itinerary will be communicated as far in advance as possible.

By submitting this form you agree to the following:

Refund and Cancellation Policy

Please note that all camp fees are non-refundable. If a camper's family decides not to attend camp for any reason, we are unable to offer a refund. However, we are pleased to provide a gift certificate of equal value, which can be applied toward any of our future outdoor camp sessions.
MI ESCUELITA EN ESPAÑOL
Release, Waiver, & Indemnification AgreementRelease, Waiver, & Indemnification Agreement
1. Release & Waiver of Liability
I, the undersigned parent or legal guardian, authorize my child to attend and participate in activities at Mi Escuelita en Español (“the School”). In consideration of the School permitting participation, I, on my own behalf and on behalf of my child, fully release and waive any claims against the School, its employees, directors, agents, volunteers, sponsors, and affiliates (collectively, “Released Parties”), for any injury, illness, loss, or damage related to my child’s participation, unless caused by the gross negligence or willful misconduct of the Released Parties.

2. Indemnification & Defense
I agree to defend, indemnify, and hold harmless the Released Parties against any and all claims, including legal defense costs and attorney’s fees, brought by third parties or on behalf of my child arising from my child’s actions or participation in School programs, regardless of fault. This indemnity applies to any claim except those arising from the intentional acts or gross negligence of the Released Parties.

3. Medical Treatment Authorization
In case of medical or dental emergency, I authorize the Released Parties to secure treatment for my child and agree to assume all costs incurred.

4. Assumption of Risk
I understand and accept that participation in daily activities (such as arts, crafts, dance, games, playground play) carries inherent risks of injury or illness, and voluntarily accept such risks on behalf of my child.
PLEASE SEND YOUR CHILD WITH COMFORTABLE CLOTHES AND SHOES. ADDITIONALLY A SMALL BACKPACK WITH:

LUNCH
WATER BOTTLE
SUNSCREEN

PLEASE DON'T SEND NUTS, SWEETS, OR CANDIES

TO BE CONSIDERED ENROLLED, PLEASE SEND PAYMENT AND FILL OUT THE WAIVER FORM ON THE NEXT PAGE. GRACIAS!

Name of parent*

NameLast name

Parent's signature*

Name of camper(s)*

Age(s)*

Name*

NameLast name

Phone number*

Format: (000) 000-0000.

Name*

NameLast name

Phone number*

Format: (000) 000-0000.

Necessary Medical Information:

YesNo

If yes, please explain:

YesNo

Name of Insurance Provider

Phone number

Policy number

YesNo

E-mail:*

Outdoor Camp 2026 Mi Escuelita en Español Enrollment Form

Mi Escuelita en Espanol : A place to learn, create and explore in Spanish...

Payment methods

In case of emergency, contact (other than parents)

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