Small Fry Camp Registration Form

  = Required Information

Announcements

Your registration will not be submitted if there is missing or incomplete information.

Household Information

Your Information

Contact Information

Child One Information

Please select the Small Fry Camp programs you would like your child to attend:

Selection
Camp Name
Date
Age Group
Price
  

Child Two Information

Please select the Small Fry Camp programs you would like your child to attend:

Selection
Institute Name
Date
Age Group
Price
  

Emergency Contact Information

I authorize the following individuals to pick up my child from camp

Additional Information

7/2/2020 ]

Privacy Policy

At no time will the Center for Aquatic Sciences at Adventure Aquarium sell or share the information you provide us to any third party entity. You do not need to worry about receiving SPAM (unsolicited email) because of the information you provide us.

Medical and Release Statements

Medical Release Information

1. Does your child have any allergies (food, medication, environmental)?      
  If yes, Please Specify
 
  If camper has allergies, do they carry an Epi pen and/or allergy kit? (Allergy kits must be clearly marked with your child’s first and last name.)
2. Is your child taking any medications? 
  If yes, Please Specify (If your child must take the medication during the camp day, please bring a printed copy of the dosing instructions provided by your pediatrician on your first day of camp.)
 
3. Please list any special conditions or needs (dietary, medical, emotional, etc.) that camp staff should be aware of:  
 
4. Primary Family Physician Name:  
 
5. Primary Family Physician Phone: 
 
6.. Health Insurance Company: 
 

Parental Consent Information

Field Trip Release:
I grant permission for my child to participate in field trips with the Center for Aquatic Sciences Summer Camp.  Camp staff will inform parents of all field trips in advance.  Camp staff reserves the right to cancel/reschedule field trips if necessary
Photo Consent:
I consent to the taking of and use for promotional/programmatic purposes by the Center, Adventure Aquarium or their designates of my child's name, image, and likeness, as shown in photographs, social media, motion picture film and/or electronic images, and/or audio recordings made of my child's voice during Summer Camp. I understand if I consent that such materials shall be the sole property of the Center for Aquatic Sciences at Adventure Aquarium and there will be no remuneration received by me or my child.
Medical Consent:
If my child needs emergency medical care and no one can be contacted, I give my consent for the transportation of my child by ambulance and for the administration of any treatment deemed necessary by licensed medical personnel.
If my child uses an epi-pen, I give permission for Center staff to administer the epi-pen in the case of an emergency
Behavior Policy:
The Center for Aquatic Sciences has a zero tolerance policy for bullying and/or violent behavior (verbal and/or physical). The Center reserves the right to excuse a child from camp without a refund in the event he/she is in violation of this policy. A full description of the Summer Camp Behavior Management Policy will be provided in the Camp Parent Handbook Please initial to the right).
Release:
My child will be participating in Summer Camp operated by the Center for Aquatic Sciences at Adventure Aquarium.
I do hereby waive and release the Center, and its Trustees, officers, employees, agents and contractors, of any and all liability (including attorney fees and costs) arising out of or in connection with my child's participation in the Program and transportation associated with the Program. I agree to assume financial responsibility for all medical and hospital expenses.
I/We have carefully read the Summer Camp Medical and Release statements and fully understand its contents.(Please Electronically Sign and Date Below)
7/2/2020 ]
   
 

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