Tuesday Camp Registration

Please use this form to submit your registration for the Be Their Hero Summer Camp on TUESDAYS.

 

Carr Park
Lewis Avenue, Temperance, MI

July 18, 25; August 1, 8

10:00 AM - 11:15 AM



RELEASE & AUTHORIZATION

      In consideration for the right to participate in the MCISD Be Their Hero From Age Zero Summer Camp 2017, I individually and collectively for myself, my heirs, executors, administrators and assigns do waive and release any and all claims by my child,  by me or  on behalf of me for property loss, personal injury, emotional distress, wrongful death, product liability, strict liability and/or negligent rescue which may incur against the Monroe County ISD, its sponsors, agents, representatives, board members, employees, contractors and suppliers for any and all damages which I or my child might sustain and suffer in connection with  par Pticipation in the MCISD Be Their Hero From Age Zero Summer Camp 2017. 
      The student and/or student’s parent or guardian authorizes and/or otherwise consents to his/her student being the subject of photographs, videotapes or audiotapes, or combinations thereof, that are taken, shot or recorded during the MCISD Be Their Hero From Age Zero Summer Camp 2017.  Such productions may be copied, copyrighted, edited and distributed by MCISD in the manner described above. This release specifically authorizes the reproduction, sale, exhibition, broadcast and/or distribution of this material without limitation.

By my signature (name typed below) on this Authorization, I agree that I have read, understood and agree to the terms of the Release and Authorization.


SIGNATURE RELEASE
To confirm acknowledgement of
the above language,
mm/dd/yyyy
PARENT INFORMATION
CHILD INFORMATION
Does the child have allergies?  (required)
Does child have special needs?  (required)
Is child involved in a group?  (required)
CAMP INFORMATION