Amistad Summer Camp Registration 23-24

Summer Camp Registration -Registracion de campamento de Verano 9-4:30pm

June17- July 5, 2024
Student Information
Student's Name*

First NameLast Name
Birth Date*

MonthDayYear
Sibling's Name ATTENDING Camp (optional)

First NameLast Name
Birth Date

MonthDayYear
Sibling's Name ATTENDING Camp (optional)

First NameLast Name
Birth Date

MonthDayYear
Address*

Street Address

Street Address Line 2

City

Zip Code
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*

Area CodePhone Number
E-mail*
Confirm E-mail*
example@example.com
What School does your child attend?*
Emergency Information Other than the name listed above
Emergency Contact's Name*

First NameLast Name
Relationship*
Emergency Contact Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Seattle Amistad School during the selected camp.
AgreeI do not agree
Media Disclosure Seattle Amistad School may periodically photograph students participating and working during camp. These photographs may be used in a variety of ways; Public relations and marketing purposes: images printed on brochures, posters, and newsletters, Website, Facebook Page, and/or other art, education, or news related publications. Please indicate whether you will allow publication of photographs taken of your child/children during Camp. Names will not be included in photographs or posted on social media. We appreciate your support and would love the chance to share pictures of all of the fun being had at our Summer Reading Camp. You can also follow us on Facebook to capture all of the pictures yourself!
AgreeI do not agree
Please read Amistad Policies and Procedures
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.
Signature

Clear
Checkout

Registration includes registration AND camp date selection. Students are not enrolled until full payment is received. Discount for siblings 10%
Price Registration Fee $465 each week, except the week fisrt week of July $$279!

Summer Camp*

Week1, June 17- 21(June 19 No camp/ Holiday)

$372.00 Number of Students

Week2, June 24- 28

$465.00 Number of Students

Week3, July 1- 5

$279.00 Number of Students

Total

$0.00

Credit Card

Should be Empty:

Summer Camp Registration -Registracion de campamento de Verano 9-4:30pm

Checkout

Credit Card