Pre-College Art Portfolio Camp Registration

Parent/Guardian Information

Emergency Information

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Nataliya Gurshman during the selected camp. In exchange for the acceptance of said child’s candidacy by Nataliya Gurshman, I assume all risks and hazards incidental to the conduct of the activities, and release, absolve, and hold harmless Nataliya Gurshman and all its respective officers, agents, and representatives from any and all liability for injuries to the said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Nataliya Gurshman including all teachers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities, including swimming. Some of these injuries include but are not limited to, the risk of fractures, paralysis, or death.

COVID-19 Policies

The safety of our campers, staff, and community is the priority. Our plan includes:

Limiting camp enrollment per session to 7 students maximum
Implementing cleaning procedures and policies before and after sessions, and,
Monitoring to make any additional mid-course corrections

Masks are optional but highly recommended

We ask that campers and guardians follow these guidelines to participate in our camps.

A required digital contact form must be submitted before the first day of camp.
We ask that parents monitor their child’s health each morning and keep campers at home if they are feeling unwell.

**Camp Drop-off & Pick-up**

Camp drop-off and pick-up will be done outside of the building to limit contact between parents, other campers, and our staff.

Location:

8365 Thompson Rd.,
Annandale, VA 22003
(Strathmeade Community Pool House)

Free Parking is available in front of the building.

 

Cancellation Policy

We encourage campers to sign up as early as possible! Nataliya Gurshman will cancel a camp if does not have sufficient enrollment (4 campers) 1-2 weeks before the start of the camp.

 

Late Pick-Up Policy

Nataliya Gurshman will charge a late pick-up fee for any camper remaining 15 minutes after camp has ended. The late fee is $20 (cash only) per 15 minutes beyond the 15-minute grace period. Late fees must be paid before a camper can participate in the next camp session.

 

Inclement Weather Policy

Nataliya Gurshman follows Fairfax County's inclement weather announcements.

When does Nataliya Gurshman issue a refund for a class or camp?

Nataliya Gurshman issues refunds when we cancel a class or activity. Nataliya Gurshman also issues refunds when it changes a class or activity and the change makes it impossible for the participant to continue with the class. Please note, Nataliya Gurshman cancels a class one week prior to the start date if the class does not meet minimum enrollment.

Once a class, camp, or activity is in session, refunds may be granted only for medical reasons or for extenuating circumstances as determined by Nataliya Gurshman.

Patrons who submit refund requests 14 days or more before the start date of a class or activity, will be granted a full refund. Refunds requests made 7-13 days before camp begins, may receive 50% refund for registration. Any refund request received less than a week before starting date, without proof of emergency, will not receive a refund for cancellation. The amount paid for the class can instead be credited to that individual’s account and can be applied to another art class.

Medical Release and Authorization

As Parent and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination, and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Nataliya Gurshman and its affiliates including staff to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of the life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.