Spring Break Camp Registration

Spring Break Camp Registration – March 16–20
Thank you for your interest in our Spring Break Camp! Camp will run Monday through Friday, March 16–20.

Campers are grouped by age and will be assigned to one of the following sessions based on age and availability:

• AM Session: 9:00–11:00 AM
• PM Session: 12:00–2:00 PM (Campers must eat lunch prior to arrival)

Camp Tuition: $200 for the week
A $50 deposit is required to reserve your child’s spot.
The remaining $150 balance is due by March 6.

If the remaining balance is not received by March 6, the camper’s spot may be released and the deposit forfeited. If the camp reaches full capacity before placement is confirmed, the deposit will be refunded.

Spots are limited and filled on a first-come, first-served basis.
Please complete the form below to secure your child’s registration.
Child's Name*

First NameLast Name
Child's Age*
Parent/Guardian's Name*

First NameLast Name
Parent/Guardian's Email*
example@example.com
Parent/Guardian's Phone Number*
Please enter a valid phone number.
Select Your Preferred Session Time*

AM Session (9:00-11:00 AM)PM Session (12:00-2:00 PM - must eat lunch before arrival)Either Session
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone*
Please enter a valid phone number.
Relationship to Child*
Allergies or Medical Conditions We Should Be Aware Of

Camp Tuition Policies & Payment Agreement
Total camp tuition is $200.

A $50 deposit is required to reserve your child’s spot.
The remaining $150 balance is due by March 6.

If full payment is not received by March 6, your child’s spot may be released and the $50 deposit will be forfeited.

If the camp reaches full capacity before placement is confirmed, your deposit will be refunded.

No refunds will be issued after March 6.

Spots are limited and filled on a first-come, first-served basis.
My signature below affirms that I have read and agree to the Camp Tuition & Payment Policy.*

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Photo & Media Release
Please mark below whether or not you grant permission for photos or videos of your child to be taken during camp activities for promotional or marketing purposes (website, social media, flyers), without compensation. No names will be publicly shared.*

Yes, I grant permission for photos or videos of my child to be taken during camp activities to be used for promotional or marketing purposes.No, I do NOT grant permission for photos or videos of my child to be taken during camp activities to be used for promotional or marketing purposes.
Liability Waiver & Medical Authorization
I, parent/guardian name* , give permission for my child to participate in Spring Break Camp from March 16–20.
I understand that participation in camp activities may include physical movement, games, recreational activities, and group interaction. I acknowledge that there are inherent risks associated with participation in such activities, including but not limited to minor injuries, falls, or accidents. I voluntarily assume full responsibility for any risks, injuries, or damages that may occur as a result of my child’s participation.
I certify that my child is physically able to participate in camp activities and that I have disclosed any medical conditions, allergies, or special needs that may affect participation.
In the event of an illness or injury, I authorize camp staff to provide basic first aid and, if necessary, seek emergency medical treatment for my child. I understand that every reasonable effort will be made to contact me or the listed emergency contact in such an event. I accept responsibility for any medical expenses incurred.
Camper Expectations
To ensure a safe and positive experience for everyone, campers are expected to:
- Follow staff directions related to safety
- Keep their hands, feet, and bodies safe
- Use materials and equipment appropriately
- Respect personal space and boundaries
- Participate in a way that supports a safe group environment
If a child becomes dysregulated, or struggles with behavior, staff will provide reasonable support, redirection, and guidance to help the child regain regulation.

However, if a child engages in behavior that is not safe — including behavior that may cause harm to themselves, other campers, or staff — a parent/guardian may be contacted and required to pick up their child early.

If not-safe behavior continues or poses an ongoing safety concern, the camp reserves the right to dismiss the child from the program in order to maintain a safe environment for all participants.

No refunds (including deposit or tuition payments) will be issued in the event of early pickup or dismissal due to safety-related behavioral concerns.
Signature*

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My Products

Spring Break Camp DepositThe remaining balance of $150 is due by March 6. If the balance is not received by March 6, the spot may be released and the deposit forfeited. Deposit will only be refunded if camp space becomes unavailable.

$50.00 Quantity

Camp Tuition, Payment in FullFull tuition payment for Spring Break Camp (March 16–20). This payment secures your child’s spot. No additional payment will be required. No refunds will be issued after March 6.

$200.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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Spring Break Camp Registration – March 16–20

Camp Tuition Policies & Payment Agreement

Photo & Media Release

Liability Waiver & Medical Authorization

Camper Expectations