Summer Adventure Day Camp
Enrollment Packet 2025
Child's Information
Name
*
First Name
Last Name
Birthday
*
-
Month
-
Day
Year
Date
Gender
*
Physician's Name
*
Physician's Address
*
Physician's Phone Number
*
Please enter a valid phone number.
Child's Allergies & a completed food allergy emergency plan for the child, if applicable
Are your child's required immunizations, vision and hearing screening, and TB screening are current and on file at their school?
*
Yes
No
School Attending
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Phone Number
*
Upcoming Grade Level (2025-2026 School Year)
*
Does your child have a sibling attending camp the same week, and if so, what is their sibling's name?
Does your child require special care?
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Yes
No
If yes please list limitations or restrictions on activities, special care required (accommodations or modifications, adaptive equipment and how to use the equipment, symptoms or indications of potential complications that may warrant prevention or intervention, and any medications prescribed for continuous, long-term use)
Shirt Size
*
YXS
YS
YM
YL
AXS
AS
AM
AL
AXL
Name on sling bag (tag)
*
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Parent Guardian Information
Name
*
First Name
Last Name
Relationship to Child
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Emergency Information
Emergency Contact Other Than Parents
Child's Name
*
First Name
Last Name
Emergency Contact Name (other than parents)
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Medical Attention
I give consent for the facility to secure any and all necessary emergency medical care for my child
*
In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to physician or specific hospital.
*
Physician Name or Hospital
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
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Transportation & Field Trips
I give consent for my child to be transported and supervised by the operation's employees to and from Little Creek at TexStar
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Yes
No
I give consent for my child to participate in field trips
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Yes
No
I give consent for my child to be transported and supervised by the operation's employees on field trips
*
Yes
No
I give my child permission to participate in water activities.
*
Yes
No
Is your child able to swim without assistance?
*
Yes
No
Field Trip Waiver
(If not signed, child will not be permitted to attend camp on Field Trip Days. These are posted in the Information Packet)
This form is to authorize my child’s participation in all field trips organized and conducted by Little Creek at TexStar.This form is also a statement of release of liability as detailed below.Note: Information will be sent home prior to each field trip detailing where the field trip will take place. You, the parent/guardian, will be allowed to disallow your child’s participation in any outing should you choose to do so by not signing them up for that specific camp day.The undersigned Parent/Guardian (hereinafter, “I”) understands that the students will be chaperoned/supervised while en route, participating and during schedule time, and that normal precautions will be taken in their interest for safety and well-being.I hereby agree to release Little Creek at TexStar and its trustees, employees, volunteers and sponsors (collectively, the “Indemnities”) and to indemnify and hold the indemnities harmless form all actions, claims, liability, and expenses, whether known or unknown, present or future (and expressly including (1) actions brought or claims made by the student named above after reaching the age of majority, and (2) actions or claims for damages caused in whole or in part by the negligence or gross negligence of the indemnities) relating to or arising from or connected in any manner with the student’s participation in the field trip identified herein.In case of emergency, I give my approval and authorization for first-aid treatment and any medical treatment by local physicians and/or hospital including surgical procedures. I agree to accept responsibility for payment of all charges incurred during this medical treatment.
Transportation Waiver
(If not signed, child will not be permitted to attend camp on Field Trip Days. These are posted in the Information Packet)
I authorize Little Creek at TexStar to transport my minor child in a company Bus or Van, driven by an individual authorized by Little Creek at TexStar. I understand my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or staff or volunteer. I understand participation in the identified event is not a requirement for participation in the program.I have read, understand, and discussed with my child:(1) My child will travel in a motor vehicle driven by an adult and my child is to wear their safety belt duringtravel;(2) My child is expected to listen to supervising staff/driver, respect staff and other children, the vehicles theyride in, and the people they travel with during the trip;(3) Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions or acts by riders,other drivers, or objects; and,(4) My child is to remain in their seat and not be disruptive to the driver of the vehicle.I recognize participation in this activity, as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify I have been advised of the potential risks, and I have full knowledge of the risks involved in this activity, and I assume any expenses incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses.As a condition for the transportation received, I, for myself, my child, my executors and assigns, further agree to release and forever discharge Little Creek at TexStar, TexStar Athletics, and their agents, officers, employees and volunteers from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation.I have read this entire waiver and authorization form, I fully understand its terms and conditions, and I agree to be legally bound by its terms.
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Camp Policies
I understand that Tuition will be due by the Monday two weeks prior to your Camp Date. Tuition will be drafted the Monday two weeks before for the registered camp week if it has not already been paid. If tuition has not been paid two week prior to camp date, my child's spot will no longer be held and late sign up tuition rate will apply. Once I am registered, tuition will be due whether my child is able to attend or not. I understand that No refunds or makeups available. I understand that the registration fee & deposit(s) are non refundable. -A late fee of $25 for the first minute per child, plus $1 for each additional minute per child, will be charged for pick-ups after 6:00 PM. Late fees must be paid at the time of pick-up, and the child will not be allowed to return until all outstanding fees are paid in full. Repeated late pick-ups may result in removal from the program, with no refunds for prepaid services.
*
PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT BETWEEN THE PARENT/GUARDIAN (I) AND LITTLE CREEK AT TEXSTAR/ TEXSTAR ATHLETICS. THIS FULLY SIGNED FORM MUST BE SUBMITTED BY A PARENT OR LEGAL GUARDIAN BEFORE ANY CHILD IS ALLOWED TO PARTICIPATE IN THE ABOVE REFERENCED CAMP.I, the undersigned, wish for my Child (hereafter “Child”) to participate in the above referenced camp (hereafter “Camp”) on the date(s) and location indicated above and, in consideration for my Child’s participation, I hereby agree as follows:I acknowledge, understand and appreciate that as part of my Child’s participation in the Camp there are dangers, hazards and inherent risks to which my Child may be exposed, including the risk of serious physical injury, temporary or permanent disability, and death, as well as economic and property loss. I further realize that participating in the Camp may involve risks and dangers, both known and unknown, and have elected to allow my Child to take part in the Camp.I, on behalf of my Child, hereby understand and acknowledge that my failure to disclose relevant information may result in harm to my child and/or others during this Camp. By signing my name, I represent and warrant that my child's mental, physical or medical condition enables him/her to participate in the Camp without any special accommodation.I, on behalf of my Child, hereby release Little Creek at TexStar, TexStar Athletics, Administration, Faculty, Staff, Student Leaders, Camp Staff, and all other officers, directors, employees and agents from any and all liability as to any right of action that may accrue to my heirs or representatives for any injury to my Child or loss that my Child may suffer while training, preparing, participating and/or traveling to or from the Camp. This agreement is binding on my heirs and assigns.I, on behalf of my Child, furthermore release, indemnify and hold harmless Little Creek at TexStar/ TexStar Athletics from and against any and all liability, actions, debts, claims and demands of every kind whatsoever, specifically including, but not limited to, any claim for negligence or negligent acts or omissions and any present or future claim, loss or liability for injury to person or property that my Child may suffer, for which my Child may be liable to any other person, that may or does arise out of my Child’s participation in the Camp. I understand that Little Creek at TexStar/TexStar Athletics accepts no responsibility for my Child’s personal property.I, on behalf of my Child, furthermore acknowledge that Little Creek at TexStar does not provide on-site medical care or provide and administer any prescription or over-the-counter drugs and in the event of an accident or serious illness, I hereby authorize representatives of Little Creek at TexStar to obtain emergency medical treatment for my Child on my behalf. I hereby hold harmless and agree to indemnify Little Creek at TexStar/TexStar Athletics from any claims, causes of action, damages and/or liabilities, arising out of or resulting from said medical treatment. I further agree to accept full responsibility for all expenses, including medical expenses that may derive from any injuries to my Child that may occur during his/her participation in the Camp.
*
By signing below, I acknowledge that Little Creek at TexStar and TexStar may use photos or videos of students for marketing purposes, including print ads, the website, commercials, and other promotional materials. I understand that my child's image or video may appear in these advertisements. Rest assured, these images will never be sold or shared with outside companies or individuals.If you would like to request an exception to this policy, please notify our office.
*
I understand that Little Creek at TexStar will provide two snacks for my child. With this being said, I understand that if my child has severe (life-threatening) food allergy, I am recommended to bring our own snacks and that no alternative snacks will be provided.. I will need to contact the Camp Director with any severe food allergy questions. I do not hold Little Creek at TexStar or TexStar Athletics liable for any incidents that may occur due to a food allergy.
*
I understand that I will need to send a sack lunch to camp with my child each day they are enrolled. TexStar will not provide lunch.
*
I give Little Creek at TexStar permission to apply sunscreen
*
Little Creek at TexStar wants to ensure a fun and safe camp environment for all participants so we have a ZERO tolerance bullying policy. Parents or guardians will be informed of the incident to discuss corrective solutions. There will be a “three-strike” policy for repeated disruptive behavior. Camp staff has the right to immediately dismiss a child from camp due to violent or disruptive behavior. This includes any inappropriate physical and verbal behaviors (examples: hitting and cursing) First instance: The child will receive a verbal warning and parent or guardian will be informed at the end of the day.Second instance: The parent of guardian will be notified immediately and asked to pick the child up from camp for the day. Third instance: The child will be dismissed from the remaining days of camp with no refund for prepaid programs. By signing, I understand and agree to Little Creek at TexStar's Behavioral/Discipline Policy
*
I understand that this packet DOES NOT ENROLL MY CHILD IN CAMP. I will need to log into my customer portal and select the weeks/days I will be enrolling my child in and pay the deposit(s).
*
What date will your child first attend Summer Day Camp?
*
-
Month
-
Day
Year
Date
I have read through the Parent Handbook Above in its entirety and agree to abide by all policies listed in the Handbook.
*
Camp Registration Fee
*
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Registration Fee
Camp registration fee is required to be submitted before you are able to enroll in any weeks of Camp. This fee includes your Camp T-Shirt and Personalized Sling Bag.
$
65.00
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