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Bridges Summer Camp

admin@bridgescamp.org

607 North Hampton Rd., Suite D, DeSoto, TX, 75115, US

214-390-6548

Bridges Summer Enrichment Camp Enrollment Application

Bridges Summer Camp is a program developed by Comprehensive Academic and Social Enrochment Solutions Inc., a 501(c)(3) organization.

 

General Information

Primary Parent or Legal Guardian Information

Home Address

Additional Authorized Guardian(s)

What outcomes would you like your child to achieve by participating in the Bridges Summer Enrichment Programs? Select all that apply.

We want to get to know your kids!

Student Information

Student Date of Birth

Student Information

Student Date of Birth

Spring 2017 - Info

Student Information

Student Date of Birth

Spring 2017 - Info

Medical Information and Emergency Contact

Emergency Contact #1

Emergency Contact #2

The camp fees include lunch and afternoon snacks. However, breakfast will only be available only to students who select the option. Those students who elect to participate in breakfast will be assessed an additional fee. Breakfast will be available from 7:30 a.m. until 8 a.m.

Breakfast Meal Option

Waivers and Releases

The following sections address several topics including but not limited to the release of photos, video, consent to participate in field trips and on-site liability.

Official Documentation Acknowledgement

I acknowledge that I will need to provide official documents related to my child prior to the start of camp including, but not limited to report cards, other academic or legal documents.

Photo and Video Release

I hereby grant permission to the rights of my child's image, likeness and sound of my child's voice as recorded on audio or video tape without payment or any other consideration. I understand that my child's image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my child's likeness appears.

Additionally, I waive any right to royalties or other compensation arising or related to the use of my child's image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area.

Photographic, audio or video recordings may be used for the following purposes:

• conference presentations • educational presentations or courses • informational presentations • on-line educational courses • educational videos

By signing this release I understand this permission signifies that photographic or video recordings of my child may be electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only.

By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

Field Trip Acknowledgement

I hereby acknowledge that the scheduled field trips are a critical part of the Bridges Camp experience. I understand that my child will be encouraged to participate in the field trips. I understand that the fees associated with field trips have been included in camp costs and will not be refunded due to non-participation.

Payment Acknowledgement

I hereby acknowledge my review of the fee schedule for Bridges Summer Camp, 2017 session. I fully understand that a non-refundable registration payment in the amount of $160 is due to reserve a space for my child. The registration fee is requird for every child. The multi-child discount does not apply to registration fees.

I further acknowledge that the unpaid balance of all camp fees is due in advance of camp participation.

Parent or Guardian Signature

Choose how to sign

Thank you so much for your interest in Bridges Camp. After online payment is complete, please answer a few more optional questions about you and your child.

Income and Demographic Information

Does your child usually qualify for free or reduced lunch?

How did you hear about Bridges Summer Enrichment Program?

Payment is not required at this time. However, payments are due prior to the first day of camp. Pay in full, or make weekly payments in-person or online. To make a payment online, visit Eventbrite.com and Search -- Bridges Summer Camp, DeSoto, TX Call 214-390-6548 for other options.