Adventure Summer Day Camp

Parent Guardian Information
Name*

First NameLast Name
Relationship to Child*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Information
Emergency Contact Other Than Parents
Child's Name*

First NameLast Name
Emergency Contact Name (other than parents)*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Medical Attention
I give consent for the facility to secure any and all necessary emergency medical care for my child*

Clear
In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to physician or specific hospital.*

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Physician Name or Hospital*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Camp Policies
I understand that Tuition will be due by the Monday two weeks prior to your Camp Date.  Tuition will be drafted the Monday two weeks before for the registered camp week if it has not already been paid. If tuition has not been paid two week prior to camp date, late sign up tuition rate will apply. Once I am registered, tuition will be due whether my child is able to attend or not. I understand that  No refunds or makeups available. I understand that the registration fee (deposit) is non refundable. -I understand that a late fee of $25 will be charged if my child is not picked up by 6:00pm.*

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PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT BETWEEN THE PARENT/GUARDIAN (I) AND LITTLE CREEK AT TEXSTAR/ TEXSTAR ATHLETICS. THIS FULLY SIGNED FORM MUST BE SUBMITTED BY A PARENT OR LEGAL GUARDIAN BEFORE ANY CHILD IS ALLOWED TO PARTICIPATE IN THE ABOVE REFERENCED CAMP.I, the undersigned, wish for my Child (hereafter “Child”) to participate in the above referenced camp (hereafter “Camp”) on the date(s) and location indicated above and, in consideration for my Child’s participation, I hereby agree as follows:I acknowledge, understand and appreciate that as part of my Child’s participation in the Camp there are dangers, hazards and inherent risks to which my Child may be exposed, including the risk of serious physical injury, temporary or permanent disability, and death, as well as economic and property loss. I further realize that participating in the Camp may involve risks and dangers, both known and unknown, and have elected to allow my Child to take part in the Camp.I, on behalf of my Child, hereby understand and acknowledge that my failure to disclose relevant information may result in harm to my child and/or others during this Camp. By signing my name, I represent and warrant that my child's mental, physical or medical condition enables him/her to participate in the Camp without any special accommodation.I, on behalf of my Child, hereby release Little Creek at TexStar, TexStar Athletics, Administration, Faculty, Staff, Student Leaders, Camp Staff, and all other officers, directors, employees and agents from any and all liability as to any right of action that may accrue to my heirs or representatives for any injury to my Child or loss that my Child may suffer while training, preparing, participating and/or traveling to or from the Camp. This agreement is binding on my heirs and assigns.I, on behalf of my Child, furthermore release, indemnify and hold harmless Little Creek at TexStar/ TexStar Athletics from and against any and all liability, actions, debts, claims and demands of every kind whatsoever, specifically including, but not limited to, any claim for negligence or negligent acts or omissions and any present or future claim, loss or liability for injury to person or property that my Child may suffer, for which my Child may be liable to any other person, that may or does arise out of my Child’s participation in the Camp. I understand that Little Creek at TexStar/TexStar Athletics accepts no responsibility for my Child’s personal property.I, on behalf of my Child, furthermore acknowledge that Little Creek at TexStar does not provide on-site medical care or provide and administer any prescription or over-the-counter drugs and in the event of an accident or serious illness, I hereby authorize representatives of Little Creek at TexStar to obtain emergency medical treatment for my Child on my behalf. I hereby hold harmless and agree to indemnify Little Creek at TexStar/TexStar Athletics from any claims, causes of action, damages and/or liabilities, arising out of or resulting from said medical treatment. I further agree to accept full responsibility for all expenses, including medical expenses that may derive from any injuries to my Child that may occur during his/her participation in the Camp.*

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By checking the appropriate box below I, on behalf of my Child agree or disagree to give Little Creek at permission to use the electronic image of my Child on TexStar Athletics’ website or in Little Creek at TexStar/TexStar Athletics publications and I agree to indemnify and hold harmless Little Creek at TexStar/ TexStar Athletics, its Board of Trustees, Administration, Faculty, Staff, Student Leaders, Camp Staff, and all other officers, directors, employees and agents from any and all liability as to any right of action that may accrue to my heirs and assigns as a result of Little Creek at TexStar/ TexStar Athletics using my Child’s image.*

AgreeDisagree
I understand that Little Creek at TexStar will provide lunch and two snacks for my child. With this being said, I understand that if my child has severe (life-threatening) food allergy, I am recommended to bring our own snacks and lunches and that no alternative lunches will be provided.. I will need to contact the Camp Director with any severe food allergy questions. I do not hold Little Creek at TexStar or TexStar Athletics liable for any incidents that may occur due to a food allergy.*

Clear
I give Little Creek at TexStar permission to apply sunscreen*

Clear
Little Creek at TexStar wants to ensure a fun and safe camp environment for all participants so we have a ZERO tolerance bullying policy. Parents or guardians will be informed of the incident to discuss corrective solutions. There will be a “three-strike” policy for repeated disruptive behavior. Camp staff has the right to immediately dismiss a child from camp due to violent or disruptive behavior. This includes any inappropriate physical and verbal behaviors (examples: hitting and cursing) First instance: The child will receive a verbal warning and parent or guardian will be informed at the end of the day.Second instance: The parent of guardian will be notified immediately and asked to pick the child up from camp for the day. Third instance: The child will be dismissed from the remaining days of camp with no refund for prepaid programs. By signing, I understand and agree to Little Creek at TexStar's Behavioral/Discipline Policy*

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I understand that this packet DOES NOT ENROLL MY CHILD IN CAMP. I will need to log into my customer portal and select the weeks/days I will be enrolling my child in. *

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What date will your child first attend Summer Day Camp?*

MonthDayYear
Date
I have read through the Parent Handbook Above in its entirety and agree to abide by all policies listed in the Handbook.*

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Camp Registration Fee
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Registration Fee
Camp registration fee is required to be submitted before you are able to enroll in any weeks of Camp. This fee includes your Camp T-Shirt and Personalized Sling Bag.

$65.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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Summer Adventure Day Camp

Child's Information

Parent Guardian Information

Emergency Information

Emergency Contact Other Than Parents

Emergency Medical Attention

Transportation & Field Trips

Field Trip Waiver

Transportation Waiver

Camp Policies