2018 Saint Anne's Summer Camp Registration
Two Year Olds through Four Year Olds

Please check if applicable:
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Does your child have allergies or health conditions? *
Does your child have an Epipen? *
Emergency Contact Information
Please list people other than parents who will represent you if we can not reach either parent. *
 NamePhone
1.
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St. Anne’s Day School and Enrichment Programs

2018 Summer Camp Agreement

The entity "St. Anne's" in this agreement refers to:  St. Anne's Episcopal Church, Inc., and all its Advisory Council programs, including but not limited to St. Anne's Day School and Enrichment Programs; including but not limited to the Infant and Toddler Enrichment Programs, the After School Programs, and the Summer Camps -- and all staff, teachers, directors, administrators, employees or agents, including volunteers of St. Anne's Episcopal Church and its Advisory Council programs.

I understand that St. Anne’s Day School is not a licensed program, is not required to be licensed by the Georgia Department of Early Care and Learning, and is exempt from the state licensure requirements. For more information, contact Bright from the Start Georgia Department of Early Care and Learning at 404-657-5562 or www.decal.ga.gov.

In consideration of my child's being accepted by St. Anne's, neither I, my spouse nor my child will hold St. Anne's liable for any accident, loss or injury to my child occurring while attending St. Anne's, on the playground of the Church or in any fashion connected with activities of St. Anne's, whether such activity takes place on the Church grounds or otherwise, including travel by car or bus, unless such accident, loss or injury is caused by the negligence of St. Anne's, in which case I shall limit any claim I have or file to no more than the liability insurance coverage of St. Anne's.

I specifically give permission for my child to take walking field trips. No further permission is required by us for our child to go on such trips when they occur.

I hereby consent to allow St. Anne’s Day School to use my child’s likeness, photograph, words, voice, name, drawings or other representations of my child’s thinking in presentations for professional development, for school-related websites and blogs, for communications with families of Day School students, and for publicizing and promoting St. Anne’s Day School.  I hereby hold harmless and waive all claims against St. Anne’s Day School with respect to any liability arising from the use thereof.

I understand that there will be no refunds and that the fees are not refundable or transferable once it is determined there is room for my child.

In the event of an emergency requiring immediate medical attention, the staff members of St. Anne's are authorized to consent to such medical treatment for my child as is deemed immediately necessary.  I further understand that I or the persons whose emergency telephone numbers appear on the registration form will also be notified as quickly as possible and that my child's pediatrician will also be called, if necessary.  Furthermore, I understand that health insurance on my child is not the responsibility of St. Anne's.

I understand that there are rules and procedures established by St. Anne's which will be provided to me in letter form prior to the start of camp, with updates provided if necessary, and that these rules and procedures have been established to provide the best possible care for all children enrolled in St. Anne's, and I agree to abide by these.  I also understand that my child may be dismissed by St. Anne's without prior notice, if in the sole opinion of St. Anne's it is in the best interest of the child or the school to do so.

I understand that if the other parent of my child and I are divorced or separated, St. Anne's will follow the instructions of the parent having legal custody of the child in the most recent applicable court order or, in the absence of a court order, the instructions of the parent with whom the child is then residing in determining the person to whom the child will be released.

I certify that my child’s immunizations (or exemption) are up to date.

I have read and understand the above agreement and will abide by the policies herein.

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Please indicate weeks you wish to enroll. Ages are as of September 1, 2018. Fees are $197 per week.
 Week 1
(June 4-8)
Week 2
(June 11-15)
Week 3
(June 18-22)
Week 4
(June 25-29)
Week 5
(July 9-13)
Two Year Olds
Three Year Olds
Four Year Olds
Please indicate the total number of weeks you wish to attend. (Only check one box.) *

Fees are not refundable or transferable.