Sol Sparks Summer Program Registration Form

Summer Camp Registration
Child’s Information
- Child’s Name*
  
  First NameLast Name
- Birth Date*
  
  MonthDayYear
- Grade*
- MaleFemale
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Child’s Name
  
  First NameLast Name
- Birth Date
  
  MonthDayYear
- Grade
- MaleFemale
- Address (if different from parent/guardian)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Child’s Name
  
  First NameLast Name
- Birth Date
  
  MonthDayYear
- Grade
- MaleFemale
- Address (if different from parent/guardian)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Parent/Guardian Information
- Name*
  
  First NameLast Name
- Home Number
  Format: (000) 000-0000.
- Cell Number*
  Format: (000) 000-0000.
- E-mail*
  example@example.com
- Emergency Information
- Emergency Contact's Name*
  
  First NameLast Name
- Relationship*
- Phone Number*
  Format: (000) 000-0000.
- Alt. Phone Number
  Format: (000) 000-0000.
- Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.*
- Is the child prescribed an inhaler, or epi pen? If yes, please explain any instructions.*
- Operating Hours:
  
  Sol Sparks Summer Program begins every day at 8:30AM and runs until 3:30PM.
  
  Late Pick-up Policy:
  
  We understand that schedules can sometimes be challenging to manage, and we value your commitment to the Sol Sparks Summer Program. If, for any reason, you anticipate being unable to pick up your child on time, we kindly request that you inform us as soon as possible.
  
  At Sol Sparks, we strive to provide a safe and organized environment for all participants. To ensure we have sufficient time to clean and prepare for the following day, we will make every effort to accommodate exceptional circumstances on a case-by-case basis. Your cooperation and timely communication will greatly assist us in making suitable arrangements.
  
  In situations where children remain in our care beyond the designated pickup time of 3:30 PM, we have implemented a late pickup policy. This policy incurs a fee of $30 per hour, considering the additional supervision and resources required. We sincerely appreciate your understanding regarding this matter, as it enables us to maintain the program's high standards and ensure the well-being of all participants.
  
  Should you have any questions or concerns regarding pickup arrangements or our program policies, please do not hesitate to reach out. Thank you kindly for your understanding on this matter.
  
  Registration Deposit & Follow-up:
  
  A $100 non-refundable Registration deposit is required to hold the desired dates, covers administrative fees and goes towards your child's time at Sol Sparks. After your registration form is submitted, we will follow up with how you would like to proceed with payment as well as date reservations.
  
  In the event you book and pay for an entire month, the registration deposit will be waived.
- Informed Consent and Acknowledgement
  
  I hereby give my approval for my child’s participation in any and all activities prepared by Sol Sparks during the selected camp days. In exchange for the acceptance of said child’s candidacy by Sol Sparks, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Sol Sparks and all its respective officers, agents, and representatives from any and all liability for injuries to 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 Sol Sparks, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is always a risk of being injured, including fractures, paralysis or death, that is inherent in all affilliated activities, but not limited to, sports, outdoor activities and excursions.
- Medical Release and Authorization
  
  As Parent and/or Guardian of the named child, 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 child. 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 the Sol Sparks and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.
  
  Medication Authorization: We require written consent from a parent or legal guardian before administering any medication to a child. The authorization form should include detailed instructions regarding the medication, dosage, frequency, and any additional information deemed necessary.
  
  Medication Drop-off: Parents or guardians should personally deliver the medication to the program staff. It is crucial to hand over the medication in its original packaging, clearly labeled with the child's name, the name of the medication, the dosage, and any specific instructions.
  
  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 life and limb of the named minor child, in my absence.
- Pricing subject to Change
  
  Please note that due to varying circumstances such as staffing requirements, variable hours, and other factors, pricing may be subject to change. We will notify you if this is required.
- 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.
- Date*
  
  MonthDayYear
  Date
- Signature*
  
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Summer Camp Registration

Child’s Information