2025 SUMMER CAMP REGISTRATION

2025 SUMMER CAMP REGISTRATION
Please fill out and submit one registration form per camper

Camp Dates:

Monday, June 16 to Friday, August 8, 2025.

(Entering 1st through 5th grade and at least 6 years old)

Camp Location:

1724 Santa Clara Avenue

Alameda, CA 94501

Camp Time:

From 8:00am to 5:30pm

Camper's Information
Name*

First NameLast Name
Address*

Street Address

Apartment Number

CityState / Province

Postal / Zip Code
Entering Grade In 2025-2026*
Age*
Birthdate*

MonthDayYear
Date
Parent / Guardian Name*
Address (If Different from Camper)

Address

Street Address Line 2

CityState / Province

Zip Code
Primary Phone number*
E mail Address*

Confirmation Emailexample@example.com
Parent / Guardian 2 Name
Address (if different from participant)

Address

Street Address Line 2

CityState / Province

Zip Code
Phone number
E mail Address

Confirmation Emailexample@example.com
How did you hear about Girls Inc.?
2025 Summer Camp

Transfer and Camp Refund Policy

CAMP REFUND POLICY & PROCESSING:

All cancellation requests must be submitted in writing to:Caroline Ford, Assistant Director of Programs at aford@girlsincislandcity.org.
- Cancellation requests made before May 2, 2025 will be subject to a $60.00
  cancellation fee.
- Cancellations requests made after May 2 and up to 7 days prior to the registered camp start date. will be subject to a 50% cancellation fee.
- No refunds given with less than 7 days notice of the registered camp start date.
- In the unlikely event enrollment is below our threshold on a particular week, we reserve the right to cancel Summer Camp for that particular week. If this is the case, you will receive at least one week’s notice of camp cancellation and will be fully refunded.
TRANSFER & CHANGE POLICY:

All requests for transfers and changes must be emailed to Caroline Ford, Assistant Director of Programs at aford@girlsincislandcity.org.

A $25 fee will be charged per transaction for all transfers and changes. These will be honored as long as space is available. There are no transfers between campers or other programs we offer.
2025 Summer Camp

Payment and Camp Confirmation procedures

PAYMENT PROCEDURE:
At least 50% of the total fees are due when you receive your summer camp email
confirmation. The remaining balance must be paid on or before May 30, 2025, by
6:00pm. If the balance is not paid by this time, your child may lose her spot, and no refund of deposits will be given. All fees must be paid
before your child attends camp.
Registration taken after May 30, 2025, must be paid in full No exceptions.
Forms of payment accepted:
- Credit card (paid online)
- To pay by check please make checks payable to Girls Inc of the Island City. The Return check fee is $25.
- To pay by cash or check please stop by our main office,1724 Santa Clara Ave.
  Alameda, CA 94501 during business hours. Payments made in cash must be
  the exact amount due.
CAMP CONFIRMATION:
Upon receiving summer camp registration, we will send an email confirmation of your
summer camp registration within 1-3 business days. If you do not see your email
confirmation in your primary or spam folder, please contact us at summercamp@girlsincislandcity.org.

Once you receive your email confirmation, your invoice will be emailed alongside other camp details. If the requested week is full, you will be placed on the waitlist and notified via email.
Acknowledgement*

I understand and agree to the Payment, Enrollment Confirmation, Transfer, Change and Refund Policies listed above.
Registration fees :

$450 per week, with the exception of;

Week 1 (*June "Juneteenth" at the rate of $270).

Week 3 (**July 4th at the rate of $360).

***Center will be closed on, June 19th and 20th for Juneteenth Holiday

****Center will be closed on, July 4th for Independence Day Holiday
Please select your camp week(s):*

Week 1 June 16-18Week 2 June 23-27Week 3 June 30- July 3Week 4 July 7-11Week 5 July 14-18Week 6 July 21-25Week 7 July 29-August 1Week 8 August 4-8

Field Trip Waiver, Social Media/Photo & Liability Agreement Release
Camper's Name*

First NameLast Name
Parent/Guardian Name*
Field trip waiver (Required for Participation)

I grant permission for my child to attend all field trips and I hereby give my permission to the physician selected by the adult leader in charge to provide any necessary medical attention. All campers must attend field trips. No on-site supervision will be provided.

I understand that I am not able to drop off or pick up my child at any field trip location site.
Parent/Guardian signature*

Clear
Date*

MonthDayYear
Date
Social Media/Photo Release (optional)

I hereby authorize Girl Inc. of the Island City, its agents and others working for it or on its behalf to use my image/likeness/voice/artwork/writing in still photos, slides video productions on Girls Inc. of the Island daughter's City's accounts on social media sites (Facebook, Twitter, etc) including Girls Inc. website, for promoting and rep- resenting Girls Inc. and its programs, and do hereby grant and convey unto Girls Inc. all rights, title, and interest in the above media including but not limited to, any royalties, proceeds, or other benefits derived from such photo- graphs or recordings.
I grant the permission of media/photo release

YesNo
Parent/Guardian signature

Clear
Date

MonthDayYear
Date
Liability Agreement Release - Required for Participation

I hereby authorize, as parent or legal guardian, for my child to participate in Girls Inc. Programs. In consideration hold for this participation, I do hereby, for myself and my heirs and assigns, release and agree to indemnify and harmless Girls Incorporated of the Island City, its employees and volunteers from all liability, loss, claim, demand, action or cause of action which arises or may arise or be occasioned in any way by such participation. I also release and hold harmless Girls Inc of the Island City, its employees and volunteers from all liability, loss or claim which may occur in transporting my child for the purposes of participating in any Girls Inc. activities.
Parent/Guardian signature*

Clear
Date*

MonthDayYear
Date

2025 SUMMER CAMP REGISTRATION

Field Trip Waiver, Social Media/Photo & Liability Agreement Release

EMERGENCY AND HEALTH INFORMATION

HEALTH INFORMATION

Census Report