Summer Camp Registration

If you have additional children to register, please fill out the following fields.  If not, please skip to the next section and continue registration by filling out the Parent/Guardian information.

Parent/Guardian Information

Emergency Information

Summer Camps are first come first serve.  Also note that each camp's registration closes 10 days prior to the start of the camp being signed up for. 

 

Please select from the options below.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Monroe Country Day School (MCDS) during the selected camp. In exchange for the acceptance of said child’s candidacy by MCDS, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless MCDS and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of participating in selected camp sessions.

In case of injury to said child, I hereby waive all claims against  MCDS including all teachers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

By submitting this form, I am agreeing to these terms.

Medical Release and Authorization

As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency that requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named child. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to MCDS and its affiliates including Camp Administrators to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered camp.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

By submitting this form, I am agreeing to these terms.

Confirmation

BY ACKNOWLEDGING AND SUBMITTING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.