2018 SUMMER CAMPS
Main Street School of the Arts 2018 Camps
Child’s Name and Age:
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Guardian Name, email address and cell phone number
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Additional Guardian Name, email address and cell phone number
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DATE OF SUMMER CAMP: FULL DAY week of:
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DATE OF SUMMER CAMP: HALF DAY week of:
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Name of morning Summer camp: 1st CHOICE and 2nd CHOICE - Please include CHOICE #1 and CHOICE #2 for your morning Summer camp, in case your first choice gets cancelled due to low enrollment.
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Name of afternoon Summer camp: 1st CHOICE and 2nd CHOICE - Please include CHOICE #1 and CHOICE #2 for your afternoon Summer camp, in case your first choice gets cancelled due to low enrollment.
Your answer
BEFORE CARE (8:00 AM-9:00 AM) FULL WEEK - week of:
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AFTER CARE (4:00 PM-6:00 PM) FULL WEEK - week of:
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Emergency Care Information: Allergies/Medical Info:
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Name and phone # of Emergency contact if Parent is unavailable:
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Release of Liability: As the legal parent or guardian, I release and hold harmless Main Street School of the Arts, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Main Street School of the Arts, its owners and operators or in route to or from any of said premises. This program is exempt from Bright From the Start licensure. I've read the above and agree –please type signature:
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May I use a photo of your child for promotional materials?
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