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Ateliers Registration Form 2011

 

Thank you for your interest in our camp.

Please, fill out one form per child and click on the submit button at the end of the form. You will receive an email after submitting.

We are looking forward to meeting your child.

 

 

STUDENT INFORMATION

If you sign-up for the Open House only (first day of the camp), you will let us know your final decision one day after the open house .

Address
GUARDIANS
Guardian 1:
Phone Numbers
Guardian 2
Phone Numbers
PICK UP PROCESS

A parent or guardian must authorize up to three individuals to pick-up their child. Authorized individuals will be required to present valid identification to pick-up any child.
I authorize the following individuals to pick-up my child:

First Name/ Last Name/ Tel #

First Name/ Last Name/ Tel #

First Name/ Last Name/ Tel #

FINANCIAL AGREEMENT

- An extra-$25 applies to non-EFGB members. 

- Full tuition must be paid once registered by check only payable to efgb and mailed to efgb, 223 East St, Lexington MA 02420. 

- Should no remaining spots be available, we will hold your check and put you on a waiting list.  Check will be returned if child/adult does not participate in classes due to lack of spots. 

- A $10 late fee will be charged for each 10 minute increment or part of 10 minute increment past the scheduled pick-up time

- A late fee of $25 will be applied to payments received 10 days after the due date, $50 after 20 days. Any check returned by the bank will be subject to a $35 processing fee.

CANCELLATIONS AND REFUNDS

- Cancellations made by Nov. 15, 2011 will ensure a full refund of tuition.

- Cancellations made after Nov. 16, 2011 will not be eligible for a refund.

- If a student is unable to attend for any reason, there is no refund.There will be no replacements, substitutions or credits for single days missed.

MEDICAL INFORMATION
MEDICAL RELEASE:

I hereby authorize emergency medical care for my child. If, in the judgment of the staff, treatment is required for an injury or illness, I hereby also authorize the administering of anesthetics and recourse to other procedures deemed necessary by the attending physician. I understand that whenever possible I will be notified prior to medical treatment of my child, or at the earliest possible time should prior notice prove impossible. I am financially responsible for expenses medical care or transportation incurred.

OTHER AGREEMENT
PHOTO CONSENT

EFGB activities and events, may be photographed or videotaped for publication in EFGB informational and promotional materials. Students may appear in these photographs or videos. If you do not wish for your child's image to be used for this purpose, you must notify efgb director in writing one week prior to the start of the classes.

AGREE TO HOLD HARMLESS AGREEMENT:

I agree to hold abide by the conditions herein and agree to hold harmless, waive and release any and all rights to claims for damages against efgb, its agents and employees who may have been involved in the planning and implementation of this program.

EXCLUSION:

efgb reserves the right to exclude on a temporary or permanent basis any child whose behavior in class has a negative impact on other children or the overall performance of the class. Fees will be reimbursed on a pro-rate basis with a minimum charge of $200.