Registration Form

Family Name:

Child Name: Date of Birth:

School:

SABIS^®

Non SABIS^®

Child Name: Date of Birth:

School:

SABIS^®

Non SABIS^®

Child Name: Date of Birth:

School:

SABIS^®

Non SABIS^®

Child Name: Date of Birth:

School:

SABIS^®

Non SABIS^®

Contact Information

Parent's / Guardian's Name: Emergency Contact Person:

Phone: E-mail: Phone: E-mail:

Summer Camp Fees:

4 weeks:	Starting June 29 ending July 24	370 JDs
4 weeks:	Starting July 13 ending July 24	370 JDs
6 weeks:	Starting June 29 ending August 14	500 JDs

Transportation:

	Private Transport
	School Transport

	4 Weeks 115 JDs
	6 Weeks 165 JDs

Address: This is essential for those using school transport to ensure children are picked up and dropped off at the correct location. Parents who pay for the bus service, please note that the service does not start until the afternoon of the first day. Parents must arrange their own transport for the first morning only at 10:30 am.

Address

Name of Area: Street Name: Contact Number:

Building: Floor Number:

Medical Condition: detail any medical conditions or food allergies that your child may have.

Conditions of Admission

I, the undersigned Parent/Guardian, hereby register my son(s)/daughter(s), whose name appears below, in the school's Summer Day Camp 2014. In doing so, I acknowledge that I have read and agreed to each of the following conditions of admission:

Refund Policy: The full amount must be paid in advance. Should the student choose not to attend for some reason, fees will not be refunded.
Health: In the event of a medical or surgical emergency, I (the student's Parent/Guardian) hereby give permission to the physician, selected by the school, to secure proper treatment, (including hospitalization if necessary), for the student named below. I understand that the school will make all reasonable efforts to contact me should an emergency arise.
Waivers of Liability: I understand and acknowledge that certain activities have an increased risk of injury associated with them. I hereby release and agree to indemnify and hold harmless the school along with its staff and representatives from any or all losses.
Refusal of Application: The Summer Camp administration reserves the right to refuse admission to any applicant, based on its own sole discretion and based on history of discipline or medical condition(s), without having to provide any justification or explanation thereafter.
Photographs: Pictures will be taken during the camp of students in the different activities. Sometimes these photos are published in SABIS^® Newsletter, Yearbook, and other publications.

Child(ren) Name(s): Parent's / Guardian's Name:

Date:

Signature: