Registration Form
Parents/Guardians must complete a registration packet and submit a $40 non-refundable registration fee per child. The price of registration will be $50 after June 1st. The accepted forms of payment: Zelle, cash, and money orders are payable to Accountax School of Business. A registration fee is required to secure an opening in our program, as space is limited. Children are accepted on a first come, first served bases. *If your camper has an IEP/504 Plan/Allergies, you must provide a copy to ASB. Failure to disclose accurate information will result in dismissal form the program.
Number of Child(ren)
Please Select
1
2
3
4
5
Child 1
Plan Choice
Please Select
Standard
Gold
Premium
Child 1 Name
First Name
Last Name
Date of Birth (MM/DD/YY)
Age
Gender
Male
Female
IEP/504/Allergies
Yes
No
School Name/Grade Level
Shirt Size
Back
Next
Child 2
Plan Choice
Please Select
Standard
Gold
Premium
Child 2 Name
First Name
Last Name
Date of Birth (MM/DD/YY)
Age
Gender
Male
Female
IEP/504/Allergies
Yes
No
School Name/Grade Level
Shirt Size
Back
Next
Child 3
Plan Choice
Please Select
Standard
Gold
Premium
Child 3 Name
First Name
Last Name
Date of Birth (MM/DD/YY)
Age
Gender
Male
Female
IEP/504/Allergies
Yes
No
School Name/Grade Level
Shirt Size
Back
Next
Child 4
Plan Choice
Please Select
Standard
Gold
Premium
Child 4 Name
First Name
Last Name
Date of Birth (MM/DD/YY)
Age
Gender
Male
Female
IEP/504/Allergies
Yes
No
School Name/Grade Level
Shirt Size
Back
Next
Child 5
Plan Choice
Please Select
Standard
Gold
Premium
Child 5 Name
First Name
Last Name
Date of Birth (MM/DD/YY)
Age
Gender
Male
Female
IEP/504/Allergies
Yes
No
School Name/Grade Level
Shirt Size
Back
Next
Parent/Guardian
First Name
Last Name
Relationship
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Parent/Guardian
First Name
Last Name
Relationship
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Back
Next
Sign-Out Information
Safety is a priority for the summer program; therefore, no child enrolled in the program will be released from the program without a parent/guardian signature or that of one of the three individuals below. (Note: the names below must be of someone 16 years or older.)
Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Parent/Guardian Signature
Date
-
Month
-
Day
Year
Date
Back
Next
Acknowledgement and Media Release Form
I acknowledge that I have received and read the policies, procedures, and expectations set in the A.S.B 2024 Summer Camp Parent Handbook and agree to follow them.
Signature
Date
-
Month
-
Day
Year
Date
Media Release
I agree, as a parent/guardian of a minor participant, to grant full permission to DBA/A.S.B to use my child's photograph, videotape, or recording for promotional purposes (in print or social media) without obligation or liability to me or my family.
Child's Name
First Name
Last Name
Yes or No
Yes
No
Child's Name
First Name
Last Name
Yes or No
Yes
No
Child's Name
First Name
Last Name
Yes or No
Yes
No
Child's Name
First Name
Last Name
Yes or No
Yes
No
Child's Name
First Name
Last Name
Yes or No
Yes
No
Submit
Submit
Should be Empty: