Registering Adult Full Name *

First Name

Last Name

Registering Adult Phone *

(###)

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Camper's Full Name *

First Name

Last Name

Parent/Guardian #1 *

First Name

Last Name

Parent/Guardian #2

First Name

Last Name

I give permission for the use of photos/videos of my child and/or their artwork for Foghorn Education Center publications *

Yes

No

Authorized Pick Up #1 *

First Name

Last Name

Authorized Pick Up #1 Phone *

(###)

###

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Authorized Pick Up #2

First Name

Last Name

Authorized Pick Up #2 Phone

(###)

###

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

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In consideration for allowing your child to participate in the Foghorn Education Center Summer Camp, as his/her/their parent or guardian I affirm and represent to Foghorn Education Center that (1) I understand that participating in any activity involves a risk of injury or harm, (2) all risks are being assumed knowingly and voluntarily, including but not limited to transportation to and from the camp, (3) I certify that my child is in good health and has no physical condition that would prevent my child from participating in camp, (4) in the event that I am unable to be located, I give permission to the Program Authorities to take such measures as they deem appropriate until I am able to be contacted, (5) I do not hold Foghorn Education Center, its employees or agents responsible for any injury or other harm that results from program participation. Refund policy: All class registrations are non-refundable with the exception of those that have been canceled due to low enrollment. Foghorn Education Center reserves the right to cancel any camps in which case a full refund is issued. Foghorn Education Center Rules of Conduct. Failure to comply with these rules will result in the immediate dismissal of the child from camp with no refunds given: (1) The possession or use of alcohol and other drugs, fireworks, guns, and other weapons is prohibited. (2) Participant may not leave the camp without permission of a Foghorn Education Center employee. (3) No violence or bullying of any kind will be tolerated. (4) No use of tobacco products. (5) Participants must follow all safety rules in accordance with guidelines set out by program administrators. (6) Misuse, damage, or theft of property is prohibited. I accept these policies (Y/N) *

Yes

No