The Children's Schoolhouse Summer Camp Application

Summer Camp Registration
Child Information
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Cell Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Does your child have any allergies or medical conditions? If yes, please specify.
Is the child or parents/grandparents CSH alumni? Year(s) attended:
Tuition

Tuition is $135 weekly for current/alumni students and $150 weekly for the general public. Tuition is due with registration. Once a child is admitted to a camp session, tuition is non-refundable. Tuition can be paid via check, or on the Schoolhouse website: www.thechildrensschoolhouse.org under the “Donate” Tab select the summer camp option. Please make checks payable to: The Children’s Schoolhouse Mail Application and checks to: Attention: Summer Camps The Children’s Schoolhouse 17616 Caldwell Station Rd Huntersville, NC 28078
Summer Camp Sessions

June 3-7: Farmer Camp Farm life comes to camp this week. Children will plant and harvest their own vegetables, play outside and enjoy the simple life!June 10-14: Artist Camp Get ready to create beautiful art pieces with paint and items that come from the outdoors! We will get creative and make beautiful artwork from nature all around.June 17-21: Gardener Camp Grab a shovel, and plant in our raised garden beds. Work in the greenhouse, and plant seeds to take home!June 24-28: Digging Dirt Camp Play in the mud kitchen making mud pies and an assortment of mud food, build sand castles and enjoy getting dirty!July 8-12: Water Camp A week of getting wet! We will make rivers for the boats float down and have water slides and sprinkler-fun. Children will engage in outdoor water play and use their imaginations to explore water with various materials.July 15 – 19: Chef Camp Harvest from our garden and make delicious and healthy treats based upon available produce. Each child will bring home a cookbook from the recipes they made all week.July 22-26: Construction Camp Dig, mix, and build. Dress up in hard hats, tool belts, and use real tools. Play with bulldozers and trucks to form your own roads.July 29-August 2: Combo Camp. A combination of all the fun themes and activities from previous camps!
2024 Summer Camp Release and Hold Harmless Agreement

This RELEASE AND HOLD HARMLESS Agreement is executed on signed date by and between The Children’s Schoolhouse and the child whose name is printed below. The child whose name is printed below, together with his/her parent or legal guardian, is referred to herein as the “Participant.”

IN CONSIDERATION of being permitted to enter and use the grounds and other facilities of The Children’s Schoolhouse, and other good and valuable consideration, the sufficiency of which is hereby acknowledged, the Participant hereby agrees to the following terms:

PARTICIPANT hereby releases, waives, and discharges The Children’s Schoolhouse, its officers, directors, employees, volunteers or teaching staff, and each of them (collectively referred to as “The Schoolhouse”), from any and all liability to Participant for any and all loss or damage to Participant on account of injury to the Participant or the Participant's personal property, while the Participant is participating in any of the activities sponsored or conducted by The Schoolhouse.

PARTICIPANT further agrees to indemnify The Schoolhouse from any loss, liability, damage or cost that The Schoolhouse may incur due to any harm suffered by the Participant. Participant agrees to never institute suit or action against The Schoolhouse for damages, cost, expenses, or loss of services resulting or arising from any such loss, damage or injuries.

PARTICIPANT acknowledges that he/she is financially responsible for any medical cost related to any injuries sustained while at The Schoolhouse. Because the Participant is a minor, this Release and Hold Harmless Agreement shall be executed by a parent or legal guardian, and shall be binding upon said parent or legal guardian as well as upon participating minor. Said parent or guardian by the execution hereof, waives all claims to their individual or derivative capacity, as well as claims on behalf of Participant.

PARTICIPANT expressly agrees that the Release and Hold Harmless Agreement is intended to be as broad and inclusive as permitted by the laws of the State of North Carolina, and that if any portion hereof is held invalid, it is agreed that the balance shall notwithstanding continue in full legal force and effect.
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

Powered by Jotform SignClear
Should be Empty:

Summer Camp Registration

Child Information

Tuition