Mental Toughness and Fundamentals Basketball Camp 2020

The Webb School Code of Conduct for Webb Summer Programs

The Webb School Overnight camp is designed for learning and fun, and the health, welfare, and safety of all participants is of great importance. Campers will be required to follow the rules below at all times to promote the enjoyment of all participants and to ensure their safety and the safety of others:
1. Comply with the reasonable instructions and directions of teachers and counselors promptly, without argument or resistance;
2. Cooperate with and treat fellow campers, teachers, and counselors with dignity, courtesy, and respect;
3. Stay in the classroom, dormitories or lab with the teacher/counselor at all times, and, if outdoors, keep the teacher/counselor in view at all times.
Students will be advised of the rules on the first day of camp. The director will visit each class and reiterate the rules and ask for questions. The teachers and/or counselors will quickly go over the rules at the beginning of each day of class.

If a student fails to comply with these rules or the reasonable instructions of the teachers and counselors, the school reserves the right to terminate the camper's participation in the program immediately. If a participant is asked to leave the Summer Program classes, the tuition (and bus fees, if applicable) will be refunded at a prorated amount. Please sign and date below, indicating your understanding and agreement with the rules and procedures outlined above. Failure to sign this agreement will result in the student being denied access to the camp programs.
Camper's Name *
I accept the rules outlined above.
Date *

Month Day Year
Date

Medical Report to be completed by Parent or Guardian
Does your child have any current medical conditions, concerns, or limitations of which we need to be aware?
List any medications that will need to be administered by Webb School personnel. Please provide medication name and dosage information.
Does student use an inhaler?

Yes No
If an inhaler is used, indicate how often.
If yes, please be sure the Student has one during the duration of his or her time at The Webb School.
Please list any food/medication/environmental allergies?
Does your child require an Epi-Pen?

Yes No
Are there any over the counter medications (ex: Ibuprofen, Nyquil, Mucinex) you do NOT want your child to take?
Does your child have any special dietary needs?
If yes, please explain above.
Are there any other physical/mental/emotional factors we should be aware of in caring for your child?
If yes, please explain above.

Medical Insurance Information
Name of Insurance Company
Group #
Policy Holder Name
Policy Holder ID
Policy Holder DOB

Month Day Year
Date
Please upload a picture of the Front and Back of Your Insurance Card

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Cancel of
Alternately you can send pictures of your Insurance Card using SMS/iMessage from your phone. Create a new email to sdouglas@webbschool.com and attach the images.

Permissions Release

Parent hereby authorizes and consents to Student’s participation in all School activities, including, but not limited to, athletics/physical education activities, any School-sponsored trip away from the School, including the utilization of any transportation supplied by the School (such as buses) for such activities, unless the School receives timely written notice to the contrary. Although it is understood that the School and its representatives intend to take reasonable precautions with respect to all activities, Parent understands that the participation of Student in such activities involves a certain element of risk, Parent releases and holds The Webb School and its agents, administrators, managers, employees, trustees and representatives (“Released Parties”) harmless from any and all liability and/or claims, suits, property damage, illness, accidents, injury, or loss whether arising before, during, or after such activities which are not the result of willful misconduct of any of the Released Parties and agrees not to sue any Released Party for any claims released herein.
Consent *

I agree with the Permissions Release terms
Medical Authorization

If, in the opinion of a properly licensed and practicing physician, Student needs medical or surgical services which require Parent’s pre-authorization or consent, Parent hereby authorizes, appoints, and empowers the School to act as Parent and furnish such consent on Parent’s behalf. Parent confirms that it is Parent’s desire that Student be furnished with such medical or surgical services as soon as reasonably possible after the need arises. Parent hereby releases and holds the School harmless from any liability which might arise from the giving of such consent. Parent agrees to reimburse the School for any medical expenditure made on Student’s behalf.
Consent *

I agree with the Medical Authorization terms
Consent to On Site Medical Care

Parent hereby authorizes the School to supply medical care as needed for Student (including administration of allergy medications, Epi-Pens, etc. according to the Student’s prescription from a licensed practitioner) or other minor medical care as determined to be appropriate by the School nurse. Parent hereby releases and holds the School harmless from any liability which might arise from the provision of such medical care.
Consent *

I agree with the Consent to On Site Medical Care terms
Media Release

I give The Webb School permission to use my child’s name and/or photographic/electronic image to promote The Webb School in any electronic or print media, news/photo releases, advertisements distributed to media outlets, internal/external school publications, social media and marketing materials, (i.e.: The Webb School Facebook Page, Webb Beat E-Newsletter, etc.).
Consent

I agree with the Media Release I DO NOT agree with the Media Release
Electronic Signature

I hereby attach my electronic signature to and agree to the terms and conditions of the terms above. I understand that my electronic signature is legally binding and may not be invalidated solely on the basis that my signature was electronically obtained.
Parent/Guardian Name *

First Name Last Name
Date *

Month Day Year
Date
Parent/Guardian Name

First Name Last Name
Date

Month Day Year
Date

Webb School Summer Programs

Mental Toughness and Basketball Skills Camp - July 20-24 $ 250.00

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Mental Toughness and Fundamentals Basketball Camp

Medical Insurance Information

Permissions Release

Medical Authorization

Consent to On Site Medical Care

Media Release

Electronic Signature