Beaumont School Enrichment Opportunities

Athletic Youth Nights

Athletic Clinics

Registration

Student First Name: *

Student Last Name: *

Student's Birthdate * +

Student's School *

Other (Please type in the name of your Child's school) *

Student's Grade *

Parent First Name *

Parent Last Name *

Cell Phone Number of Parent Contact: *

E-Mail Address of Parent Contact: *

Student Address (For seasonal mailings from Beaumont School) *

Did Mother or Grandmother graduate from Beaumont? *

Yes

No

Please provide information for ONE alumnae relative:

First and Last Name

Graduation Year (ex: 1997)

Relation (Mother/Grandmother)

Medical Release *

I hereby authorize the camp director to act for me according to her best judgement in any emergency requiring medical attention for my daughter. I release the camp instructors, director and Beaumont School of all liability for any illness or injury incurred while at or in transit to and from camp.

Photo Consent

This application authorizes Beaumont School, its agents and employees to use the photographic images or likenesses of the enrolled child for the use and benefit of Beaumont School in its publications, marketing and promotional materials.

Current Total:

$0.00