Summit Ridge Day Camp 2015 Camper Application

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Welcome to our secure online registration system. You must complete the registration process in one session. It should take no more than 10 minutes to complete.
Please have the following information ready before you begin: Your session(s) selection, emergency contact information, medical information and a credit card for deposit payment.

You can register more than one child per family. Please select the "Add New Camper" button during the registration process. If you are elegible for a sibling discount, please contact the office via email srdc.registration@hendersonschool.com BEFORE YOU PAY IN FULL. $20 per sibling, per session will be credited to your account after deposit if received.

Registration is complete only when you receive an e-mail confirmations for the Camper Application, Deposit Payment and Medical Authorization form.

Camp balance is due in full by June 1, 2015. Please contact the SRDC Registration Coordinator at srdc.registration@hendersonschool.com with any additional questions.

'Camper' Information

  1. Grade as of Fall 2015

    'Parent 1' Information Copy contact information from 'Camper'

  1. 'Parent 2' Information Copy contact information from 'Camper'

  2. 'Emergency Contact 1' Information

  3. 'Emergency Contact 2' Information

Please Review the Terms and Conditions Below

I have read the Camp Information page provided on the camp’s website (www.SummitRidgeDayCamp.com) and understand its content and Attendance Policy. A refund may be requested in writing 2 weeks prior to the camper’s start date. Once camp has begun, all refunds will be given at Camp Director’s discretion.

I do hereby authorize Summit Ridge Day Camp (SRDC)/ Henderson International School (HIS) to provide immediate medical care, including the administration of manual AED-assisted CPR, Heimlich maneuver, oxygen or other life saving or first aid procedures in the event of a medical emergency. In such cases, I authorize SRDC/ HIS, its administrators and members of the staff to activate the 9-1-1 emergency response system. I further consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which may be deemed advisable by, and is to be rendered under the general or special supervision of any physician or surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any accredited hospital.

In the event of a medical emergency, and if HIS/SRDC personnel are unable to reach the parent(s), I give consent in loco parentis to any doctor or medical facility to administer life-saving medical or surgical treatment and care for my child. I understand and agree that I am responsible for any and all costs associated with providing emergency medical care to my child. As such, I agree to reimburse HIS/SRDC within 15 days for any costs HIS/SRDC may incur on my behalf as a result of providing emergency medical care to my child.

I understand that part of the camping experience involves activities (including but not limited to swimming) and interactions that may be new to my child, and that they hold certain risks. I am aware of these risks and I am assuming them on behalf of my child. I have instructed my child on the importance of abiding by the camp’s rules and as well following directions given to him/her to ensure their safety and well-being. If I choose not to have my child participate in a camp activity, I will inform the Camp Director and/or my child’s counselor in writing.

I understand that at times Summit Ridge Day Camp/ HIS is asked to release information regarding my child/children to school personnel, representatives of welfare, licensing and regulatory agencies, law enforcement, healthcare professionals, and any other person(s) who are deemed as serving in an official capacity as it pertains to the health, safety, and welfare of my child/children. If an inquiry regarding my child/children is from an entity other than a school or licensing agency personnel, I will be informed of the information requested.

I understand Summit Ridge Day Camp will make every effort to accommodate grouping requests, however, placement may not be guaranteed.

In the event that a day or activity is canceled as a result of hazardous conditions or other cause beyond the control of the camp, there shall not be any tuition refund or make-up day.

I agree to allow Meritas, LLC and it’s camp/school, Summit Ridge Day Camp/HIS, it’s nominees, and assign the right to record my child’s/ children’s image and/or voice and consent to allow the camp the perpetual right to use or reproduce this material in any and all media known or hereinafter devised without compensation.

I give permission for the staff at Summit Ridge Day Camp to apply a sunscreen product that is broad spectrum with SPF 30 or higher to my child, when playing outside or using the swimming pool. I understand that sunscreen may be applied to exposed skin, including but not limited to the face (except eyelids), tops of ears, nose, bare shoulders, arms and legs. If I choose not to allow a staff member to apply sunscreen, I will inform the Camp Director and/or my child’s counselor in writing.

Your credit card will be kept on file for any ancillary charges such as; Extended Care, additional camp days, and our lunch program.

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