Parent/ Guardian's name
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First Name
Last Name
Student's name
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First Name
Last Name
Age
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Gender
Male
Female
Other
Email
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Phone
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(###)
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####
Emergency Contact
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First Name
Last Name
Emergency Email
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Emergency Phone Number
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(###)
###
####
Authorization for pick up
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Camp
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Only pick ONE camp
Tuition Policy
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I understand that all tuition is paid in advance. A$20 deposit fee+ a $5 processing fee will be withheld if students cancel proper to one week before the start of camp. Tuition may not be refunded within 7 days of camp. Refunds cannot be made during the week of camp for sickness or inability to attend camp for last minute absences
Disciplinary Actions
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All campers must comply with our camp policies. Campers must be interested in participating in all activities. No alternative activities will be provided to campers who wish not to participate. They will be dismissed accordingly. By enrolling in camp, the camper and the camper's parent acknowledge that good behavior is necessary and that any camper's failure to act accordingly may result in the camper being dismissed. The parents or legal guardians of any camper dismissed for disciplinary problems shall be responsible for picking up their camper or arranging appropriate transportation home for such camper.
Photo Release
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I understand that from time to time, Oxford Art Alliance will photograph events and classes for promotional purposes. I give Oxford Art Alliance permission to use my/my child's image and name for promotional purposes.
Assumption of Risk
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I realize that during the camp, there are several ways that my child could suffer serious injury. I hereby accept all responsibility for any accident, injury, or illness that may occur in conjunction with this program. I'm releasing and hold harmless Oxford Art Alliance and all other parties involved from any and all claims, costs, liabilities and expenses including all judgement s, attorney's fees and court costs.
Voluntary Consent to Participate
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I, the undersigned, do hereby acknowledge that my child, the participant listed above, is physically fit and in a condition to fully participate in all camp activities and it is my wish for my child to participate in all camp activities. I recognize that I must make the Oxford Art Allience and all other parties involved aware off any conditions my child has that may inhibit his or her ability to participate in the camp.
Medical Treatment
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If my child is injured during camp activities, Oxford Arts Alliance may request medical services. By taking such action, the Oxford Arts Alliance and all other parties involved are not admitting any liability to provide or to continue to provide any such services. Should my child require transport to a medical facility as a result of an injury, I am financially responsible for such transportation and medical treatment costs. If my child is injured during camp, it is my child’s responsibility to notify the Oxford Arts Alliance and all parties involved immediately. I hereby hold harmless and agree to indemnify the Oxford Arts Alliance and all parties involved from any claims, causes of action, damages and/or liabilities, arising out of or resulting from said medical treatment. I further agree to accept full responsibility for any and all expenses, including medical expenses that may derive from any injuries to my Child that may occur during his/her participation in the Camp.
Medical Insurance Coverage
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I acknowledge that neither Oxford Arts Alliance nor all other parties involved shall provide medical insurance coverage to my child. My child is covered under my insurance policy. Additionally, I acknowledge that all of the information provided above is current and correct. I am executing this waiver and release for my child/me to participate in this program. I have read and agree to all terms listed.
Initials
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Parent/Guardian initials for authorization that the above information is accurate and all policies and clauses have been read thoroughly
