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Summer Camp Registration 2017


  1. 1. Step One
  2. 2. Disciplinary Policy
  3. 3. Child Pick-Up Authorization Form
  4. 4. Video Approval
  5. 5. Select the Weeks your child will be attending camp
  6. 6. Participant Travel Authorization
  7. 7. Payment
  • Step One

    1. Please initial each item

    2. I as parent, guardian or applicant over 18, agree that the City of Burlington and all individuals participating in the activity in any capacity, will not be liable for any losses, claims, or injuries of any kind arising from out of the participation of the applicant in the activity and hereby release all said individuals from such liabilities. The undersigned acknowledges that in all activities there are certain risks of physical injuries and that the applicant will participate at applicant’s own risk. In the event that the activity requires transportation, the city will not be held liable and release all individuals from liabilities.

    3. I give consent for the applicant to be photographed, videotaped or filmed while participating in the activity and for the resulting record to be used by the City of Burlington for educational and promotional purposes.

    4. In the event that my child may require medical and/or surgical care wile I am out of the city or otherwise unreachable I hereby authorize the staff to seek emergency medical care. I have read and understand the above and am signing this document of my own free will.