2021 Summer Program Registration Form
Student Name *
Date of birth *
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/
DD
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Gender *
Current School *
Grade (in 9/2021) *
Emergency Contact Phone Number *
Email *
Address *
The Regular Program(s) to attend *
Required
Summer Special Program 2021
The Special Program(s) to attend *
Required
Summer Camp Refund Policy
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I am registering my child(ren) in New Energy Education Center’s 2021 Summer Program, who is in excellent health and able to participate in all activities. I fully acknowledge that participation these programs includes but is not limited to physical exercise which could cause injury of the participant. I am voluntarily participating in these activities and assume all risks of injury to my child that might occur. I acknowledge that it is my responsibility to decide whether my child is physically fit for participation. I hereby express release and hold harmless to the Company, its servants, agents, or employees from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities including the negligence of them and any loss of theft of personal property as a result of my participation in these activities. I further agree to allow the program to use photographs or video taken during the participation for future promotion purposes. I also agree to comply with the Rules and Regulations provided. Once the class starts, there will be no refund available. I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liabilities to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect. * *
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