9th&10th Grade Girls Summer Camp Registration Form 2025

9th&10th Grade Girls
Summer Camp Registration Form
2025
NOTE
The application accepts one registration at a time. If you have two children please make two separate registrations.
Date
for 9th Grade
May 31 - June 5
(6 days - 5 nights)

for 10th Grade
May 23 - May 28
(6 days - 5 nights)

Address
609 Jeb Stuart Lane, Conroe, TX 77302

All Campers Notice

Registration Date Ends: 05/20/2025
Camper's Information
First Name*
Middle Name
Last Name*
Birth Date*

MonthDayYear
Gender*

Female
Grade*

9th10th
Address*
City*
State*
Zip*
Cell Phone*
Parent or Legal Guardian Information
Parent/Legal Guardian Full Name*

First NameLast Name
Relation*
Work Phone
Cell Phone*
Parent/Legal Guardian 2 Full Name*

First NameLast Name
Relation 2*
Work Phone 2
Cell Phone 2*
Emergency Contact Information
Full Name*

First NameLast Name
Relationship to Student*
Phone Number*
Email Confirmation
Parents Email *
Camper's Email
- Please make sure your email address is correct for the confirmation email.
Mentor Information
Mentor's Full Name*

First NameLast Name
I have filled out the waiver form*

Yes
Health Information
It is our policy to contact the parent or guardian as soon as possible in the event of a serious accident or injury. If the information has changed on the day of registration please see the health officer at that time. Please bring all medication. All prescriptions must be in the campers name and the correct dosage.
Does camper have any infectious desease or conditions?*

YesNo
If yes, please explain
All fileds are required below. If nothing applies, please put "NONE" in the box. Thanks.
Any activity the camper should be restricted from? (Swimming Pool, Canoeing, Kayaking, Golf, Aqua Park, Soccer, Basketball, Volleyball, Table Tennis, Foosball etc...)*
Any physical, mental or other condition that would require special attention or medication while at camp?*
List any past medical treatment that would be helpful for us to know.*
List any allergies (ex: bees,peanuts, dairy)*
Any dietary needs that we should know about?*
List all medications*
Swimming Pool Release
Please choose one option*

My child can swim, I hereby give permission for my child to participate in swimming and pool activities WITHOUT a Lifejacket.My child can swim, I hereby give permission for my child to participate in swimming and pool activities with a Lifejacket. (Bring your own lifejacket)My child can not swim, I hereby give permission for my child to participate in 3' deep section of swimming pool and pool activities with a Lifejacket. (Bring your own lifejacket)I do not give pool activities permission for my child.
Camper Release
I hereby release and agree to hold BRIGHT CHOICE FOUNDATION harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection with any services received from BRIGHT CHOICE FOUNDATION .

I understand that this release discharges BRIGHT CHOICE FOUNDATION from any liability or claim that I, my heirs, or any personal representatives may have against the salon with respect to any bodily injury, illness, death, drawn, medical treatment, or property damage that may arise from, or in connection to, any services received from BRIGHT CHOICE FOUNDATION.

Assumption of Risk and Waiver of Liability: In consideration of the above, I assume all risks associated with the preparation of food products supplied under this Agreement, including matters of health and safety associated thereof.

I do hereby release, waiver, discharge, and covenant not to sue BRIGHT CHOICE FOUNDATION, and their respective Trustees, officers, employees and students from liability from any and all claims including the negligence of said organizations and their respective Trustees, officers, employees, resulting in personal injury, accident, or illness, including death and property loss arising from any and all food products provided under this Agreement.

By registering to the Summer Camp hosted by BRIGHT CHOICE FOUNDATION, I also consent to and acknowledge that I may be photographed/recorded at all times before, during, and after the event by the BRIGHT CHOICE FOUNDATION staff for promotional and interorganizational purposes.

By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, you are over the age of 18 and you have read, aggreed on the camp policy. In case of medical emergency or general medical care, I give consent for medical treatment for the aboved named camper by authorized personnel. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activites. I authorize Bright Choice Foundation to use my camper's picture, testimony, and video in any promotional material(web,print,or media) My child may recieve any e-mails from the camp.
I agree to the terms & conditions
Payment Information

Deadline for first installment: 20th of April 2025.

Deadline for second installment: 20th of May 2025.

Select one option*

9th&10th Grade Summer Camp - Full Payment ($550.00 one-time payment)

9th&10th Grade Summer Camp - Two Installments($275.00 for each month)

Enter coupon

Camper Signature*

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Parent Signature*

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Electronic signature, please initial*
Should be Empty:

Camper's Information

Parent or Legal Guardian Information

Emergency Contact Information

Email Confirmation

Mentor Information

Health Information

Swimming Pool Release

Camper Release