SUMMER CAMP REGISTRATION

Hours: 7:30am - 6:00pm. (extended hours)

Regular hours are 8:30am-4:30pm

As an educational camp, we look forward to having your child ready for school next year.

All days are filled with fun learning activities.

Activities include crafts, experiments, football, basketball, kickball, French and Mandarin art classes, yoga, sound engineering and game coding.

All campers will engage in academic study time which focuses on math, reading comprehension and writing skills.

There are 2 major trips for the summer which include Bush Gardens and Wild Adventures.

*Please have your child eat breakfast before arrival.
*Lunch is not included***

Westside
2151 Lane Ave S unit 101
Jacksonville, FL 32210

Camp Program Rates (please put 0s in the boxes that you are not using for the form to process) *

	Summer Camp Full Week $110
	Extended day 7:30am -6pm $160

GUARDIAN/PARENT'S NAME *

EMAIL ADDRESS *

PHONE NUMBER *

CHILD'S NAME *

Age *

Sibling Attending? *

Yes

CHILD'S NAME

Age

CHILD'S NAME

Age

Emergency Contact Information: Name and Number *

Allergies *

Other Information:

WAIVER & RELEASE OF ALL CLAIMS & ASSUMPTION OF RISK

The Youth Education Center Corporation program, including its officials, partnering organizations, employees, agents and volunteers are staff members of The Youth Education Center Corporation and are herby covered by this waiver agreement.

This waiver and release of all claims and assumption of risk can only be signed by a parent/guardian, whom is 18 years or older, of the listed participant(s) in the registration form above. Please read this form carefully and be aware that in signing up a participant of this program/activity you agree to all terms and statements in this form: I recognize and acknowledge that there are certain risks of physical injury associated with participating in this program/activity. I acknowledge that The Youth Education Center is a nonprofit that provides educational programs to participants which include but is not limited to minor children.

I agree that the selection of this program is my decision and that in signing this form I am voluntarily including the participant named in this form to be a participant in all activities, events, trips, lessons, of The Youth Education Center. I voluntarily agree to assume the full risk of any injuries, damages, loss, regardless of severity including death, that the participant may sustain as a result of such participation as it is my decision to voluntarily register the listed participant. I agree that the participant listed in this form will participate in The Youth Education Center during operation hours of 7am – 6pm with the extension as far as 5am-12midnight in the event of a long trip or parent consented event. I understand that the selection of this program is my responsibility, and that The Youth Education Center, including its officials, partnering organizations, employees, agents and volunteers shall not be liable for any claims, demands, injuries, damages, or loss of property arising out of or in connection with The Youth Education Center and the camps use of services and facilities.

I further agree to waive the right to persecute, sue, or hold responsible The Youth Education Center Corporation for injuries, damages or loss, regardless of severity which the participant may accrue during their participation within the hours of operation of participation in this program/activity. I do hereby fully release and forever discharge The Youth Education Center Corporation, including its officials, partnering organizations, employees, agents and volunteers, from any and all claims for injuries, damages, loss/death of/to my minor child/ward may have or which may accrue out of, connected with, or in any way associated with this program/activity while they are in attendance.

I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims.

I agree with all that is stated in this waiver and release of all claims and assumption of risk and so I sign my name below in acknowledgment and agreement.

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