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Summer Registration Form
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                                      Escuelita Art-es

                                 Summer Arts Camp 2020

                                         Registration Form

Student Name: ___________________________ Age: _________ Birthday:_______________

Parent Name:_________________________ Email: ___________________________________


Phone (hm/wk/cell):_____________________________________________________________

Camps Schedule is 9am-3:00pm

Session 1 (June 1st - 26th)                                Summer Tuition Per Session

Week 1: Bollywood (June 1st - 5th)                                Session 1 June 1st - 26th  $1200

Week 2: Lil’ Foodies (June 8th - 12th)                        Session 2 July 6th - 31st  $1200

Week 3: Passport to France (June 15th - 19th)                Session 3 August 3rd - 21st  $875

Week 4: Crystals, Potions and Wands (June 22nd - 26th)        *One week option available. Contact

                                                                Odette Solitaire (512) 965-3604.


Session 2 (July 6th - July 31st)

Week 1: Arts and Etiquette (July 6th - 10th)                          

Week 2: Survival Skills (July 13th - 17th)

Week 3: Bollywood (20th - 24th)

Week 4: Lil’ Foodie (July 27th - 31st)

Session 3 (August 3rd - 21st)

Week 1: Passport to France  (August 3rd - 7th)

Week 2: Crystals, Potions and Wands  (August 10th - 14th)

Week 3: Survival Skills (August 17th - 21st)

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 ___________________________________________________