Summer Camp Registration 2026

Summer Camp Registration

Complete the registration form using the information from the PDF. Required fields should be filled out before submission.
Student Information
Child Name

First NameMiddle NameLast Name
Gender
Birthdate

MonthDayYear
Date
Grade Entering in Fall 2026
School District
T-Shirt Size
Parent / Guardian Contact Information
Parent's Name

First NameLast Name
Email Address
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contacts
Emergency Contact 1 Name
Emergency Contact 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2 Name
Emergency Contact 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Consent, Releases, and Signatures
Release and Hold Harmless Agreement

I herewith releases The Chosen Few Arts Council their agents, directors, officers, volunteers, and employees (the released parties) for any and all liability for injuries or damages that result either directly or otherwise from my participation or the participation of the minor named above in the above-described program, even if these injuries and damages arise as the result of negligence or culpable conduct on the part of the parties released. I further agree to indemnify and hold harmless the released parties named above for all claims against the released parties for expenses incurred by the released parties which are due to my participation, or the participation of the minor named above in the above-described program.
Release and Hold Harmless Agreement - Signature
Media/Photo Consent

The undersigned, on behalf of myself and the people listed below, do hereby consent to the use by The Chosen Few Arts Council of our name, photograph(s), likeness and voice for the use and reuse in conjunction with broadcasting, publicizing, and advertising. I further grant The Chosen Few Arts Council the right to license others to use and reuse the above-cited material in the same manner.
Media/Photo Consent - Signature
General & COVID-19 Hold Harmless

I the undersigned hereby release and holds harmless The Chosen Few Arts Council and affiliated entities, officers, directors, employees, agents volunteers and contractors from any claim, demand, loss liability, illness, death, damages and attorney fees and cost whatsoever arising from, related to, or resulting from a the Fine Arts Summer Camp with guarantee, including any such claim, demand, loss, liabilities, illness, death, damages and attorney fees and costs related to COVID -19 and/or the COVID -19 pandemic brought or suffered by a youth/or member of the youth’s household and/or family.
General & COVID-19 Hold Harmless - Parent’s Signature
Daily Temperature Check Consent

In line with COVID - 19 protection requirements, I the undersigned give my permission to allow my child temperature to be taken daily before he/she can attend camp.
Daily Temperature Check Consent - Parent’s Signature
Date

MonthDayYear
Should be Empty:

Summer Camp Registration

Student Information

Parent / Guardian Contact Information

Emergency Contacts

Consent, Releases, and Signatures