• INNOVATION LAB Summer Program Camper Registration

    Please complete this form to register a camper for our summer program.

  • CAMPER'S INFORMATION

  • Camper's Birthdate*
     - -
  • Gender*

  • PARENT'S/GUARDIAN'S INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • EMERGENCY CONTACT INFORMATION

  • AUTHORIZED PICK-UP PERSONS INFORMATION

  • For the safety and security of all children, only individuals listed below will be permitted to pick up your child from the program.

    A valid government-issued photo ID must be presented at pickup.

    Any changes to this list must be submitted in writing and approved by administration before the end of the program day.

    Please list up to three (3) authorized persons in addition to the parent/guardian.

  • MEDICAL INFORMATION

  • Does your child have any medical conditions?*
  • Does your child have any allergies?*
  • Is your child on any medication?*

  • DIETARY & LUNCH INFORMATION

  • Does your child have dietary restrictions?*
  • Does your child have food allergies?*

  • ATTENDANCE INFORMATION

  • Age Group
  • Please select the week(s) your child will be attending:

  • CAMP ADD-ONS

    Please indicate your preferences below. These selections will be used to calculate your child’s total camp fee.
  • Would you like to enroll your child in aftercare?*

  • AGREEMENTS & SIGNATURES

  • LIABILITY WAIVER

    Program Acknowledgment
    The undersigned understands that the participant is enrolling in and participating in a summer camp program organized and operated by The Corporate Trainer, Professional Development and Certification Institute. Program activities may include educational, S.T.E.A.M., technology, recreational, indoor, outdoor, and team-building activities conducted at approved locations, including facilities located at Fusion Superplex.

    The undersigned further acknowledges that Fusion Superplex is being used solely as a venue location and is not responsible for the planning, supervision, staffing, management, or operation of the summer camp program.


    Assumption of Risk
    The undersigned understands and acknowledges that participation in camp activities may involve certain risks, including but not limited to minor injuries, slips and falls, physical exertion, recreational activity-related incidents, allergic reactions, illness, transportation-related incidents, accidental damage or loss of personal property, use of equipment and technology tools, and other unforeseen incidents.

    The undersigned voluntarily accepts and assumes all risks associated with participation in the program.


    Release of Liability
    In consideration for participation in the summer camp program, the undersigned hereby releases, waives, and holds harmless The Corporate Trainer Professional Development and Certification Institute, including its directors, employees, facilitators, trainers, volunteers, contractors, representatives, program coordinators, activity supervisors, and any authorized individuals assisting with camp operations, from any and all claims, liabilities, damages, expenses, losses, injuries, or causes of action arising out of or related to participation in the program, except where prohibited by law.


    Medical Authorization
    The undersigned confirms that the participant is medically fit to participate in camp activities unless otherwise disclosed by the parent/guardian.

    The undersigned authorizes camp representatives to obtain emergency medical treatment for the participant if deemed necessary and if the parent/guardian cannot be immediately contacted. The parent/guardian accepts full responsibility for any medical expenses incurred.


    Photo, Video, and Media Release
    The undersigned grants permission to The Corporate Trainer Professional Development and Certification Institute to photograph, video record, and use images, audio recordings, testimonials, and participant work for educational, promotional, marketing, website, and social media purposes without compensation.


    Code of Conduct Acknowledgment
    The undersigned understands that participants are expected to behave respectfully and follow all camp rules, instructions, and safety guidelines.

    The organizers reserve the right to dismiss any participant for unsafe behavior, bullying, repeated misconduct, disrespect toward staff or participants, possession of prohibited items, or any behavior that disrupts camp operations or compromises the safety of others. No refunds may be issued in cases involving dismissal due to misconduct.


    Parent/Guardian Declaration
    By signing below, the undersigned confirms that they have read and understood this waiver and consent form, voluntarily agree to the terms stated herein, and confirm that they are the parent or legal guardian of the participant and are authorized to sign this form.

     

  • I Acknowledgment, Agreement and Confirm that:*
  • Date*
     - -

  • PAYMENT INSTRUCTIONS

    To secure your child’s seat in the A.I. + S.T.E.A.M. Innovation Lab Summer Camp, the required $50.00 registration payment must be submitted along with proof of payment.

    Payments may be made via direct deposit or bank transfer using the information below.

    Please use the child’s name Innovation Lab as the payment reference.

    Eg. Charles Rolle Innovation Lab - Fusion

    ⚠️ Registration is considered pending until proof of payment has been received and verified.


    IMPORTANT PAYMENT DETAILS

    • The registration fee is non-refundable.

    • Camp fees (weekly or monthly) must be paid in advance.

    • Payment must be made no later than Thursday of the prior week your child will be attending.

    • Proof of Program Fee payment is required at sign-in each Monday morning.

    This can be presented as a screenshot or digital receipt.

    Failure to provide proof of payment may result in your child not being admitted for that day/week. 

    $50.00 Registration Payment

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