March Break Camp 2025- Registration Form

March Break Camp 2025 Registration Form

Kindergarten to Grade 5 students
DATE: Monday March 17th to Friday March 21st, 2025
TIME: 8:30am until 4:30pm

COST: $425.00 per student

Limited space available. Registration is on a first come first serve basis.

*A late fee of $3 per minute for pick up after 4:30pm
I would like to register my child for the March Break Camp (17th to the 21st)
Child's Name

First NameLast Name
Grade/Class
**For Kindergarten please indicate as 0
I understand that although the school and its staff will exercise reasonable care in the supervision of my child, accidents and mishaps may occur. In the case of a medical emergency concerning my child, I give my permission for Waldorf Academy staff members to use their best judgment in obtaining medical service for my child. I agree to pay all costs incurred by Waldorf Academy in obtaining emergency medical care for my child. I also understand that in the event of illness or accident, I will be notified as soon as possible.

In addition, I hereby release Waldorf Academy and its employees and agents from all liability in respect of obtaining medical care. I also understand and agree that the school is not liable for anything that may occur due to my providing incorrect information, or my failure to give full information, regarding the physical condition of my child.
Parent/Guardian Full Name

First NameLast Name
Phone Number

Area CodePhone Number
Parent/Guardian 2 Full Name

First NameLast Name
Phone Number

Area CodePhone Number
Parent/Guardian Signature

Clear
Emergency Contact information
Emergency Contact Person

First NameLast Name
Emergency Person Phone Number

Area CodePhone Number
Relationship to Emergency Contact Person
Pick up Permission information
Please list the names and phone numbers of any people other than parents/guardians with permission to pick up your child/ren from camp; photo ID is required every day when your child gets picked-up from camp.
Designated Pick-Up Person 1:

First NameLast Name
Designated Pick-Up Person 2:

First NameLast Name
Designated Pick-Up Person 3:

First NameLast Name
Parent/Guardian Signature:

Clear
Medical Information / Allergies

Please confirm any medical information or allergies for your child
Medical information:
Allergy or food sensitivities
Registration Payment
Please submit your payment (Cost: $425.00) via etransfer to accounting@waldorfacademy.org with a message indicating the following:

Full name of your child and payment for March Break Camp 2025
Waiver & Release

I give permission for my child to to take part in activities for March Break Camp
Participant's Signature

Clear
Date Signed

MonthDayYear
Date
Should be Empty:

March Break Camp 2025 Registration Form

I would like to register my child for the March Break Camp (17th to the 21st)

Emergency Contact information

Pick up Permission information

Medical Information / Allergies

Registration Payment

Waiver & Release