Out-of-School Camp (SY 2021-22)
Register here for Out-of-School full-day skating Camp. Program operates on most no-school days, including many holidays. [Register once for the school year; email us to add/subtract dates.]
First Name(s) *
Last Name *
Phone Contact *
(during program hrs.)
Email Contact(s) *
For program info and notices
(SY 2021-22)
(Skaters must be in at least 1st Grade)
Male/Female *
Select Fall Date(s) *
Register for upcoming Out-of-School date(s): Dates can be dropped or added throughout the year, just email us to update. [Note: Program location(s) shared via email at least 2 days prior.]
Time Block
AM drop from 8:45. PM pickup by 3:15.
Transportation Service
Let us know if you'll need AM pick-up or PM drop-off - additional fee:$10/$20 (daily, one-way/round-trip). Contact/Pay driver directly: 202.465.9902 (Mr. Muhammad)
Transportation Service - Address
If you are doing home transportation service, please let us know pick-up and/or drop-off address. Driver will confirm via text or call within 48 hrs. prior to scheduled pick-up/drop-off.
Health / Other
Is there anything we need to know that may affect your child's experience at ICE Camp? (I.e., allergies; medications, etc.)
Skating Experience
Skates provided, if needed (Also: helmet, knee/elbow pads, wrist guards)
Shoe / Skate Size
Skates provided, if needed (Also: helmet, knee/elbow pads, wrist guards)
Fee / Payment Info (Fall/Winter 2019)
Payment is due on program day, Cash or Check payable to DC-ICE. [Note: Online payment options coming Fall 2020]
Program Waiver & Consent *
I certify that I am the person named below or the authorized parent or guardian of the child named below. I hereby agree to waive liability and hereby release any and all claims against DC Inner City Excellence (DC-ICE), its officers, employees and agents for injuries and damages of any nature whatsoever suffered by myself (and/or my child 18 years old or under, on whose behalf I am signing) in conjunction with any ICE program, whether on or off the skating surface and no matter whether arising in tort, contract or otherwise. If DC-ICE is found liable for injuries or damages, I agree that my sole and exclusive remedy will be against DC-ICE and not against any individual, regardless of fault. I acknowledge that ice and inline skating and other physical activities at camp involve risk of serious bodily injury. I fully accept and assume all risks and all responsibility for all losses and damages incurred as a result of my participation and for my child’s participation in these activities.
Covid-19 Waiver *
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and has significant person-to- person spread. As a result, federal and DC governments and federal and DC health agencies have recommended social distancing measures and have required ongoing prohibitions on the congregation of groups of people of various sizes. While COVID-19 can cause mild symptoms in some individuals, it can lead to severe illness and even death in others. Adults over age 65 and people of any age with serious underlying medical conditions including, but not limited to, HIV, asthma and other respiratory conditions, and pregnancy, may be a higher risk for more serious complications from COVID-19. DC-ICE has made the decision to hold Summer programs and has put in place preventative measures to reduce the spread of COVID-19, guided by the CDC and local health agencies. These include, but are not limited to, social distancing guidelines; health checks of coaches, volunteers and participants; increased cleaning protocols; required hand-washing and use of hand sanitizer; and the requirement to wear a mask during all programs involving the possibility of close - less than 6 feet - contact; however, DC-ICE cannot guarantee that you or your child will not become infected with COVID-19. Further, participating in DC-ICE programs could increase the risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participating in DC-ICE programs and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at DC-ICE’s programs may result from the actions, omissions, or negligence of myself and others, including, but not limited to, DC-ICE coaches, volunteers, and program participants and their families. My decision to continue participating in DC-ICE is exclusively my own and made in full understanding and acceptance of the foregoing risks. DC-ICE has shared this information with me and I understand my opt-out options.
Never submit passwords through Google Forms.
This form was created inside of Inner City Excellence (ICE). Report Abuse