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Camp Registration

Please complete the form below to register your child(ren) for the Young Stewards Day Camp at Viles Arboretum. A $50 deposit, per child, is required. 

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Tuition is based on a sliding-scale, income-based fee structure. Please upload form 1040 form from tax year 2020 that shows your total combined family household. If this document is not available to you, you can submit paycheck stubs for each parent/guardian responsible for the child. If no document is uploaded, you will be billed for the full amount of $350.
Payment Policy

Tuition must be paid in full by July 23, 2021

Deposit paid at registration is non-refundable, but will count towards total tuition amount due.

Once you complete this registration form, Viles Arboretum will provide you with an invoice for the total amount due according to your documentation provided and our sliding-fee scale, income-based structure. You may choose to pay in full or make payments. Payment methods accepted: credit card, check, or cash.

Parent/Guardian Contact Information
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First Name
Last Name
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First Name
Last Name



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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Child Information
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First Name
Last Name

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(mm/dd/yyyy)
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(mm/dd/yyyy)
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Please describe
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Please describe and note if camp staff will have to administer medication.

Second Child Information
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First Name
Last Name

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(mm/dd/yyyy)
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(mm/dd/yyyy)
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Please describe
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Please describe and note if camp staff will have to administer medication.

Third Child Information
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First Name
Last Name

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(mm/dd/yyyy)
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(mm/dd/yyyy)
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Please describe
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Please describe and note if camp staff will have to administer medication.
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Emergency Contact & Alternative Pickup Persons
Alternative pick up persons must show their ID when picking your child up.
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First Name
Last Name

First Name
Last Name
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First Name
Last Name

First Name
Last Name

First Name
Last Name

First Name
Last Name

Please list any persons who are not authorized to pick your child up.

In cases of separated and divorced parents, where visitation rights are denied to one parent, we cannot deny releasing the child to such parent unless a court decree or separation document is in our file expressly forbidding a parent from picking up the child from our program, or picking up at times not allowed by the court decree.

Handbook, Permissions, and Waivers
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I hereby grant an irrevocable consent to the reproduction, publication and / or sale of photographs taken of me / my child by Viles Arboretum. I agree that the images of my child may be used in any form and for any purpose whatsoever, including, editorial illustration, publications, promotional matter, advertising, trade, or gallery exhibition. I hereby release and discharge Viles Arboretum, and its officers, directors, members, volunteers, employees or agents from any and all claims and demands by me, my heirs or assigns arising out of or in connection with the use of these photographs.
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I CERTIFY THAT I HAVE BEEN PROVIDED WITH AND READ THE FAMILY HANDBOOK AND FULLY UNDERSTAND ITS CONTENT, AND AGREE TO ITS TERMS.
Accident Waiver and Release of Liability

I give permission for my child(ren) to participate in the Viles Arboretum Young Stewards Day Camp.

I understand that camp activities could include play and outdoor activities, hikes and walks in the woods wherein there could be mosquitos, bees, ticks, poison ivy, and slippery and jagged surfaces among other dangers and risks. I also understand that outdoor activities may occur in the hot sun and in the rain. I agree to see that my child is appropriately attired for camp activities, and to provide insect repellant and sunscreen for my child to use at camp. I will not expect Viles Arboretum to provide these items. I give my permission for Viles Arboretum camp staff/volunteers to apply or assist with the application of the repellant and sunscreen I provide.

In the event of illness, injury, and/or accident, I authorize the camp staff or any Viles Arboretum employee to act on my behalf. They may approve any and all non-emergency or emergency treatment and are authorized to sign any and all medical release or required form(s) on my behalf. In the event of an emergency, I understand that I will be notified of the situation as soon as practicable. I agree to pay any necessary expenses not covered by Viles Arboretum’s accident policy incurred in the medical treatment of my child, including, but not limited to all transportation costs to and from a medical facility, and, if necessary, transportation to my home or medical facility of choice.

I understand that the Viles Arboretum may, in its sole discretion, dismiss any camp participant for inappropriate, disrespectful, or dangerous behavior at any time. In this event, I understand that I will not receive a refund of camp fees for unattended days. If my child breaks or damages any property as a result of their direct or indirect behavior, I hereby agree to pay for its repair or replacement.

I understand that the risks associated with camp activities could result in injury and/or death to my child. I hereby assume these risks and, knowing them, hereby give my child permission to participate. I understand that Viles Arboretum is not liable for any injuries or other occurrences due to indoor and outdoor camp activities or related risks, and/or the actions or omissions of Viles Arboretum camp staff, volunteers, or any other entities being released.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which my child may participate, and that it will govern the actions and responsibilities at said activity.

In consideration of my application and permitting my child to participate in this activity, I hereby: WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of Viles Arboretum, it's employees, volunteers, entities or other persons released, for my child’s death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to them including their traveling to and from this activity; INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE Viles Arboretum, its trustees, officers, employees, volunteers, or other entities or persons released from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. Viles Arboretum, its Trustees, directors, officers, and all its employees, acting officially or otherwise are hereby released from any and all claims, demands, actions, or causes of action on account of any injury to my child that may occur. This release binds my heirs, executors, administrators, and/or assigns.

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