HVFS Summer Camp Enrollment Form

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HVFS Summer Camp Enrollment Form - 2025

To initiate enrollment for the HVFS Summer Camp in 2025, please fill out the form below. Please answer ALL questions to the best of your knowledge. We will contact you shortly!

Email *

Today's Date *

YYYY

Prospective Student Name (First, Middle, and Last Name) *

Child's Date of Birth *

YYYY

Main Caregiver's Full Name *

Main Caregiver's Phone Number *

Main Caregiver's Full Address *

LOCAL Emergency Full Name: *

Local Emergency Address (Street Number, Street Name, City, State, Zip Code) *

Local Emergency Phone Number *

Please Check the boxes below that correspond to the week(s) in which you wish to register your child. We require a Monday-Friday enrollment ($335/week; Sibling Discount $300/week) *

Week 1 (Ms. Jackie): June 16-20

Week 2 (Ms. Jackie): June 23-27

Week 3 (Ms. Bianca): July 21-25

Week 4 (Ms. Bianca): July 28-August 1

Required

My child has permission to go on field trips to Liking Hole Creek and the Crozet trail system adjacent to HVFS property. My child has permission to participate in all activities, including wading and/or swimming. I authorize HVFS staff to provide or consent to emergency medical care or treatment of my child (we will not administer any medication). I agree to pick up an ill child when notified. I understand that camp involves risks, and I agree not to hold HVFS liable for injuries sustained during camp or charges incurred in medical treatments, whether covered by our insurance or not. I understand that I am responsible for payment of camp fees, that these are due in full prior to my child's first day of attendance. Deposits are non-refundable and non-transferable. I acknowledge these policies and understand that this is a legal and binding agreement.

By clicking here, I acknowledge and agree to the above policy statement.

I understand that my child's spot is only reserved upon full payment of the summer camp tuition, due 5 business days after your decision to enroll. An invoice will be emailed upon confirmation of enrollment decision. *

By clicking here, I acknowledge and agree to the above policy statement.

HVFS reserves the right to terminate enrollment at any time due to, but not limited to, behavioral challenges by child and/or parent, the program's inability to meet the child's needs, late payments, and/or if caregivers are not providing the required gear. Every effort will be made to troubleshoot situations with parents and/or to give parents advance notice of this possibility. However, HVFS reserves the right to terminate enrollment at any given time if/when needed. Termination will not include refunds. *

I agree with and understand the above statement

I authorize HVFS to use pictures of my child in promotional literature and social media posts. *

Yes

I authorize HVFS to use pictures of my child in internal newsletters that are shared only with currently enrolled HVFS caregivers. *

Yes

Please tell us about your child. Be sure to tell us about some of their strengths, interests, challenges, areas for growth, and any medical or health diagnoses that have impacted your child's learning. *

What are your child's interests? *

Why is your family interested in summer camp at HVFS? *

Please share any additional information you feel may be relevant.

A copy of your responses will be emailed to the address you provided.

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