Back To School Bootcamp Registration
Hello and Welcome!

We are so excited about your interest in our Back to School Bootcamp!

Below you will find all the information we need about your child/children.
-If you have multiple children, one application per child must be filled out.

Please take the time to complete the form in its entirety.

Talk soon!
Child's Name (First and Last) *
Child's Age *
What grade is your child going into? *
Does your child have any allergies? *
If yes, what is your child allergic to?
Did your child attend The Exchange Summer Camp? *
If no, how did you hear about us?
Parent/Guardian Name *
Parent/Guardian Email *
Parent/Guardian Phone Number *
Emergency Contact #1 (Name & Phone Number) *
Emergency Contact #2 (Name & Phone Number) *
Emergency Contact #3 (Name & Phone Number) *
Terms & Conditions
You agree that the operator may authorize the physician of his/her choice to provide emergency care in the event that neither you nor the family physician can be contacted immediately.

You hereby give The Exchange Summer Boot Camp permission to photograph and video your child in the midst of Summer Boot Camp activities. These photos and videos may be posted on our social media platforms, websites and email blasts.

You agree that you and your child(ren) will be familiar with and will abide by the rules and regulations set by The Exchange Summer Boot Camp. You also accept responsibility for my child's actions while at The Exchange Summer Boot Camp.

I understand and agree that in my child participating in The Exchange Summer Boot Camp that there is a possibility of injury or other physical terms. I voluntarily agree, therefore, to assume all risks and responsibility for any such injury or accident that might occur while me or my child are in attendance at The Exchange Summer Boot Camp. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold The Exchange Summer Boot Camp, it's owners, agents, volunteers, assistants, employees, guest artists, faculty members and/or students liable for such damage, loss, injury or more. These Terms are between The Exchange Summer Boot Camp and its affiliates and “you,” the individual completing this form. You agree that this form is like any written negotiated agreement signed by you.

BY CLICKING TO ACCEPT THE TERMS, YOU AGREE TO BE BOUND BY THE TERMS THAT APPLY TO YOU AS DESCRIBED ABOVE.
Agreement
By signing your name below, you agree to the terms and conditions above.
Name of individual completing this form. *
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