Summer Camps 2024
Summer Camp registration with Lisa Smith
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Email *
Which week(s)? *
Required
Student Name *
Student Birthdate *
MM
/
DD
/
YYYY
Parent/Guardian #1 *
Telephone *
Parent/Guardian #2
Telephone
Address *
City *
State *
Zip code *
special needs/requests
I am aware that while participating in activities and functions offered by Lisa Smith’s Summer Camp, certain risks and dangers may occur. In consideration of this, I have and do hereby assume all risks and hold harmless Lisa Smith and the counselors from any and all liability, actions, causes of actions, debts, claims and demand of every kind and nature whatsoever which I now have, or which may arise from my participation in functions offered by Lisa Smith. I have read the above release and agree to the above release and assumptions of risk.
 *
I give permission for public media (e.g. radio, newspaper, local TV) to photograph, video tape or talk with my child (with the possible use of the photo, video or quote).  I give Lisa Smith and the camp counselors permission to photograph, video tape or quote my child for any external publication or website use.  I agree to allow Lisa Smith to show or upload a movie made by or including my child.
 *
Tuition options:
Increased labor and supply costs have caused me to increase tuition. If the only reason your child could not attend is financial, please inquire. I have limited scholarship assistance available. Equally, if you have additional resources to sponsor or partially sponsor a child for camp, also please inquire.
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