Kennesaw Summer Camp Registration Form

Student Information

Child's Name*

First NameLast Name

Birth Date

MonthDayYear

Age*

Gender*

MaleFemale

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name*

First NameLast Name

Cell Number*

Alternate Number*

E-mail*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Alt. Phone Number*

I am registering my child for the following camps*

Weeks 1-4 (June) : Art Camp, Music and Dance Camp, All things Spanish Camp, Nature CampWeeks 5-6 (July) : Sport Camp, Young Entrepreneur Camp, Let's get Practical Camp, Oven Made Camp

Please type Yes to verify that you understand that camps only run from 8:30am to 3:30pm

JUNE CAMPSJULY CAMPS

Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.*

Is the child prescribed an inhaler? If yes, please explain any instructions.*

Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Princeton Preparatory Schools during the selected camp. In exchange for the acceptance of said child’s candidacy by Princeton Preparatory Schools, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Princeton Preparatory Schools and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Princeton Preparatory Schools, including all coaches, teachers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball.

Confirmation BY ACKNOWLEDGING AND SIGNING 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.

Signature

Princeton Prep Summer Camp Registration