Adventure Day Camp (School Year)
Enrollment Packet for School Year 2024-2025
Child's Information
Name
*
First Name
Last Name
Birthday
*
-
Month
-
Day
Year
Date
Gender
*
Physician's Name
*
Physician's Address
*
Physician's Phone Number
*
Please enter a valid phone number.
Child's Allergies & a completed food allergy emergency plan for the child, if applicable
Are your child's required immunizations, vision and hearing screening, and TB screening are current and on file at their school?
*
Yes
No
School Attending
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Phone Number
*
Current Grade Level
*
Does your child have a sibling attending camp the same week, and if so, what is their sibling's name?
Does your child require special care?
*
Yes
No
If yes please list limitations or restrictions on activities, special care required (accommodations or modifications, adaptive equipment and how to use the equipment, symptoms or indications of potential complications that may warrant prevention or intervention, and any medications prescribed for continuous, long-term use)
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Parent Guardian Information
Name
*
First Name
Last Name
Relationship to Child
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Emergency Information
Emergency Contact Other Than Parents
Child's Name
*
First Name
Last Name
Emergency Contact Name (other than parents)
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / 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
*
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.
*
Physician Name or Hospital
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
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Camp Policies
I understand that Tuition will be due prior to your Camp Date. Tuition will be due at the time of registration. 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 a late fee of $25 will be charged if my child is not picked up by 6:00pm. I understand that my child must be registered through the portal at least 3 days prior to the camp date in order to attend.
*
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.
*
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.
*
Agree
Disagree
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.
*
I give Little Creek at TexStar permission to apply sunscreen
*
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
*
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.
*
What date will your child first attend School Year Day Camp?
*
-
Month
-
Day
Year
Date
I have read through the Parent Handbook Above in its entirety and agree to abide by all policies listed in the Handbook.
*
School Cheer Day Camp Registration Fee
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Registration Fee
School Year Day Camp registration fee is required to be submitted before you are able to enroll in any weeks of Camp. This fee is separate from summer day camp and after school care. This fee is non-refundable and will be valid through May 2025.
$
45.00
Quantity
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