Escuelita Art-es

                                 Summer Arts Camp 2019

                                         Registration Form

Student Name: ___________________________ Age: _________ Birthday:_______________

Parent Name:_________________________ Email: ___________________________________

Address:______________________________________________________________________

Phone (hm/wk/cell):_____________________________________________________________

Camps Schedule is 9am-3:30pm

Session 1 (June 3rd - 28th)                                Summer Tuition Per Session

Week 1: Bollywood (June 3rd - 7th)                                Session 1 June 3rd - 28th $1100

Week 2: Lil’ Foodies (June 10th - 14th)                        Session 2 July 1st - 26th $1100

Week 3: Moana (June 18th - 21st)                                Session 3 July 29th - Aug 16th $825

Week 4: Crystals, Potions and Wands (June 24th - 28th)        *One week option available. Contact

                                                                Odette Solitaire (512) 965-3604.

                                                                

Session 2 (July 1st - July 26th)

Week 1: 70’s (July 1st - 3rd)                          

Week 2: Survival Skills (July 8th - 12th)

Week 3: Bollywood (July 15th - 19th)

Week 4: Lil’ Foodie (July 22nd - 26th)

Session 3 (July 29th - August 16th)

Week 1: Viva Mexico! (July 29th - August 2nd)

Week 2: Crystals, Potions and Wands  (August 5th - 9th)

Week 3: Survival Skills (August 12th - 16th)

Things to Bring: Snack and Lunch. Swimsuit for outdoor water play. Come in clothes appropriate for dance movement and tumbling classes. NO DENIM PLEASE. Tap shoes, yoga mat and a drum if you have them.

                Child Medical/Photo Release for Summer Camps

This form is to authorize Escuelita Art-es Inc , their agents, representatives and employees to obtain emergency medical assistance and to provide transportation for the child herein below names, and to release Escuelita Art-es Inc from liability for injuries to children while on the school premises or otherwise in the care of the program, staff members, such as in transporting the children.

In the event that I/we cannot make arrangements for emergency medical attention at the time of the illness or accident of my child, I hereby authorize any agent, representative or employee of Escuelota Art-es Inc to take my child to Dr:_________________________________________ Phone:_______________________ Address:_________________________________________

Or to: _________________________________ Hospital, where medication or medical procedures they may deem necessary for my child’s well being will be administered. The undersigned further agrees to be financially responsible for all such medical services ,including the cost of defense and enforcement of this indemnity agreement. I further understand and agree that Escuelita Art-es Inc, its agents, representatives, or employees may administer simpler first aid in the event of minor injuries, and family members or doctors will be called when in the discretion of the School personnel, if it is deemed necessary.

I/we represent that I am parent/guardian of ____________________________________ and am fully responsible for the care and well being of the child. I agree that Escuelita Art-es Inc, shall not be liable for any damages, claims or compensation of whatever nature (including liabilities for negligence, strict liability, or otherwise) that may arise to me or for my benefit, in the name of or for the benefit of the child, or in the name of or for the benefit of any other person as a result of personal injury to the child named above while the child is on the premises of the School or otherwise in the care of Escuelita Art-es Inc, personnel, including any such injuries sustained while the child is being transported as herein authorized, and hereby agree to indemnify and hold harmless Escuelita Art-es, its agents, employees, or servants, whether paid or volunteer, against any and all claims which may arise from any injury to said child while participating in or being transported to programs of the school. Provided, however, Escuelita Art-es shall be liable for injuries resulting from gross negligence of Escuelita Art-es, its agents, representatives or employees, or injuries intentionally inflicted by Escuelita Art-es, its agents, representatives or employees.

I/we acknowledge that my child may be video taped or photographed for education, performance or advertising purposes.

I have read the foregoing and agree with it in all respects. Signed this___________ day of _________________ 2019.

Signature ___________________________________________________