Summer Camp Enrollment Form

CHILD 2 INFORMATION
Child Name*

First NameLast Name
Grade Entering in Fall*
Please tell us a little about your camper (social, learning style, comfort levels)! We'd love to know anything that might help us provide the best experience.*
Select which Summer Camp(s) you are registering for:*

[SOLD OUT - waitlist only] A World of Wonder: Nature Photography - 6/26-6/30[SOLD OUT - waitlist only] Sensory Photography: Photoplay through all 5 senses! - 7/17-7/21[SOLD OUT - waitlist only] Animation Studio: Stop Motion Animation - 8/7-8/11
Select which Summer Camp(s) you are registering for:*

[SOLD OUT - waitlist only] The Science of Photography - 6/19-6/23[SOLD OUT - waitlist only] Abstract Photography - 7/10-7/14[SOLD OUT - waitlist only] Work of Art: Mixed Media - 7/31-8/4
By selecting a waitlisted camp, you agree that if a spot opens up it will be first come first serve by order of registration.

I have read and agree to the above statement.
CAMP 2A: World of Wonder
CAMP 2B: Sensory Photography
CAMP 2C: Animation Studio
CAMP 2D: Science of Photography
CAMP 2E: Abstract Photography
CAMP 2F: Work of Art
Child 2 Subtotal
Siblings Discount Applied

MEDICAL INFORMATION
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number
List any medical or behavioral information (including allergies, medications, or prescriptions) that will help us provide a safe and respectful environment for your child*
Note N/A if nothing applies
All participants and guardians of participants assume all risks for themselves and their minor children by signing this general release of liability. Each guardian must sign this form prior to participation in the camp program at the Museum of Photographic Arts.

I release and hold harmless the Museum, it's employees and agents, from any and all liability from claims and damages which might result from:

Any injuries resulting from participation in program activities
In the case of emergency, sharing of medical information to necessary Museum staff or medical professionals
If arranged in advance, the administration of Epi-pens or other medications
If not arranged in advance, my child's self-administration of Epi-pens or other medications

I agree that in case a medical emergency arises where it is necessary for my child to be treated by other than their primary doctor, I hereby give my permission for him/her to be treated by a qualified medical professional or at a hospital. If necessary to the treatment, transportation by ambulance is also authorized. (Parent or guardian is responsible for payment of medical treatment.)
Signature*

Clear

PHOTO CONSENT
Photo Policy: The Museum of Photographic Arts (MOPA) may photograph/video my child during this program. MOPA may use photos and video footage for educational programs and/or in its public relations and marketing materials, which may include online outlets. Photos are also shared with MOPA camp families weekly though the MOPA Camp Flickr page.
After reading the statement above, I consent to the following*

I grant MOPA permission to photograph my child.I DO NOT grant MOPA permission to photograph my child.

CHILD 3 INFORMATION
Child Name*

First NameLast Name
Grade Entering in Fall*
Please tell us a little about your camper (social, learning style, comfort levels)! We'd love to know anything that might help us provide the best experience.*
Select which Summer Camp(s) you are registering for:*

[SOLD OUT - waitlist only] A World of Wonder: Nature Photography - 6/26-6/30[SOLD OUT - waitlist only] Sensory Photography: Photoplay through all 5 senses! - 7/17-7/21[SOLD OUT - waitlist only] Animation Studio: Stop Motion Animation - 8/7-8/11
Select which Summer Camp(s) you are registering for:*

[SOLD OUT - waitlist only] The Science of Photography - 6/19-6/23[SOLD OUT - waitlist only] Abstract Photography - 7/10-7/14[SOLD OUT - waitlist only] Work of Art: Mixed Media - 7/31-8/4
By selecting a waitlisted camp, you agree that if a spot opens up it will be first come first serve by order of registration.

I have read and agree to the above statement.
CAMP 3A: World of Wonder
CAMP 3B: Sensory Photography
CAMP 3C: Animation Studio
CAMP 3D: Science of Photography
CAMP 3E: Abstract Photography
CAMP 3F: Work of Art
Child 3 Subtotal
Siblings Discount Applied

MEDICAL INFORMATION
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number
List any medical or behavioral information (including allergies, medications, or prescriptions) that will help us provide a safe and respectful environment for your child*
Note N/A if nothing applies
All participants and guardians of participants assume all risks for themselves and their minor children by signing this general release of liability. Each guardian must sign this form prior to participation in the camp program at the Museum of Photographic Arts.

I release and hold harmless the Museum, it's employees and agents, from any and all liability from claims and damages which might result from:

Any injuries resulting from participation in program activities
In the case of emergency, sharing of medical information to necessary Museum staff or medical professionals
If arranged in advance, the administration of Epi-pens or other medications
If not arranged in advance, my child's self-administration of Epi-pens or other medications

I agree that in case a medical emergency arises where it is necessary for my child to be treated by other than their primary doctor, I hereby give my permission for him/her to be treated by a qualified medical professional or at a hospital. If necessary to the treatment, transportation by ambulance is also authorized. (Parent or guardian is responsible for payment of medical treatment.)
Signature*

Clear

PHOTO CONSENT
Photo Policy: The Museum of Photographic Arts (MOPA) may photograph/video my child during this program. MOPA may use photos and video footage for educational programs and/or in its public relations and marketing materials, which may include online outlets. Photos are also shared with MOPA camp families weekly though the MOPA Camp Flickr page.
After reading the statement above, I consent to the following*

I grant MOPA permission to photograph my child.I DO NOT grant MOPA permission to photograph my child.

PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*

EMERGENCY CONTACT INFORMATION
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Please list any additional people authorized to pick up your child(ren) from camp:*
How did you hear about us?

Returning camperOur websiteA friendAn email from MOPAMy child's school

CANCELLATION AND REFUND POLICY
Program sessions are subject to cancellation or change due to insufficient enrollment. You will be notified at least 7 days in advance if your session is cancelled. In this instance, you will receive a full refund in the original form of payment.

Should you choose to cancel your registration for any reason, you must provide notice 7 days before your session start date to receive a refund less a 5% administrative fee. A 50% refund will be given within 7 days of the session start date. However, the full camp fee can be allocated toward another camp during the same camp program within the same year. Cancellation refunds are issued in the original form of payment.

If your child is unable to participate in camp due to illness, we ask that you keep them at home, both for their own wellness, and to maintain a healthy environment for the other participants. We are unable to offer refunds for missed camp days because your camp fees support the operational costs of the camp as a whole. We appreciate your understanding.
Please select below to proceed*

I have read and agree to the above policy regarding my camp registration payment.

PAYMENT
Camp A Quantity Total
Camp B Quantity Total
Camp C Quantity Total
Camp D Quantity Total
Camp E Quantity Total
Camp F Quantity Total
As a scholarship applicant, please utilize code SCHOLAR at payment checkout.
Are you a MOPA Member or Balboa Park Explorer Pass holder?*

YesNo
Member ID:
Are you a military or first responder family?*

YesNo
Thank you First Responders Families and US Military Personnal Families! Use code: TYSUPPORTERS
You qualify all 2 discounts: Siblings + Responders/Military! Here is your code: TYSIBLINGS
As a MOPA Member/Balboa Pass Holder! Use code: MEMPERKS
You qualify all 2 discounts: Member/Balboa + Responders/Military! Here is your code: TYMEMBERS
You qualify all 2 discounts: Siblings + Member/Balboa Pass! Here is your code: MEMSIBLINGS
You qualify all 3 discounts! Here is your code: ALLCAMP
Your Sibling Discount has been applied!
CAMPS TOTAL
SUBTOTAL
Coupon CODE 1
Discount Percentage
Discount Amount
If you were given any special additional coupon code (not displayed above), please place here.
Coupon CODE 2 (if applicable)
Discount (Non-Percentage)
Additional Discounted Amount
Pass to Payment
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*Scholarship applicants, please note that by clicking SUBMIT below, you are only submitting your scholarship application for review and will need to wait for a separate confirmation of acceptance email. Submitting this form does not guarentee acceptance to the program.

Summer Camp Registration

REGISTRATION