Seton Summer Academy Registration
You will be contacted by email to confirm your acceptance into the Seton Summer Academy.
Email address *
Student Name *
Your answer
Grade (In September) *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
ZIP *
Your answer
Parent's Cell Phone *
Your answer
Home Phone # *
Your answer
Parent’s Email Address *
You will be contacted by email to confirm your acceptance into the Seton Summer Academy.
Your answer
Student’s Email Address *
You will be contacted by email to confirm your acceptance into the Seton Summer Academy.
Your answer
School where student is currently enrolled *
Your answer
Town *
Your answer
Please indicate your choice of schedule: *
REMINDER: Full Day students are required to bring a bagged lunch. | Please note that ART will not be offered as an afternoon option
Required
Please indicate your choice of Seton Summer Academy Courses: *
Registration choices will be assigned on a first come basis.
Required
PERMISSION SLIP FOR PARTICIPATION
1. Parent and student acknowledge and are aware that even with proper supervision, use of protective equipment and strict observance of rules, there are risks inherent in participation in the Seton Summer Academy. Parent and student hereby release, hold harmless, indemnify and discharge Mother Seton Regional High School, its employees, agents and volunteers from all liability for damages, loss or injury to persons or property arising out of or in connection with student’s participation in the above described activity that may be filed by, on behalf of, or for the above named student.

2. For purposes of this agreement, liability means all claims, demands, losses, causes of action, suits or judgments of any and every kind that arises from student’s participation in the Seton Summer Academy.

3. Parent and student further expressly agree that the foregoing release and waiver provisions are intended to be as broad and inclusive as is permitted by the law and that if any portion of it is held void, voidable, or unenforceable, the remaining portions shall remain in full force and effect.

4. The undersigned has read and voluntarily signs this release and waiver of liability and further agree that no oral representations, statements or inducements, apart from this agreement, have been made.

I hereby request that my daughter participate in the above Seton Summer Academy Program/s.

Signature of Parent/Guardian *
By typing your legal name below you acknowledge to electronically sign this form.
Your answer
Date *
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COST TO PARTICIPATE
Payment:

$275 for Half Day session
$400 for Full Day session

Please return Registration Form & Medical Consent Form with check payable to:
Mother Seton Regional High School
Mail to: Mother Seton Regional High School
Attn: Mrs. Giron, Re: Seton Summer Academy
One Valley Road
Clark, NJ 07066
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