Spring '23 Camps Registration

Parent Name*

First Last

Child Name*

First Last

Child's DOB*

Child's School*

Email Address*

Additional (Different) Email Addresses

Phone*

Allergies/Special Needs/Notes

If Adding a Second Child (Name, DOB)

If you would like to add a sibling(s) registration, please do so here, along with their DOB and week(s) attending. We will contact you for additional payment, with all sibling discounts for all children, at a later date.

Authorized Adults*

Please list all authorized adults for pick up

June 8th-9th DOE Camps

Thursday, June 8th (SOLD OUT)

Price: $0.00

Friday, June 9th (SOLD OUT)

Price: $0.00

Spring After-School Families ONLY (Same Weekday Registration)

6/8, 6/9 (Spring Families ONLY) (Same Weekday)

Price: $50.00

If you are registered for a PICK UP program in the Spring After-School Program that you are choosing the DOE Holiday Camp date on the SAME weekday, select this option. If you are registered for 2+ pick up weekdays/week in the Spring Program, or have siblings in the pick up program, your fees are waived for DOE camp dates on THAT/THOSE weekday(s) and no payment is needed. If you are registering for a camp date that is NOT on your weekday(s) in the Spring Program, please select the full DOE camp price above.

Total

$0.00

COVID Vaccine Card Upload

Max. file size: 300 MB.

If you haven't sent us your child's vaccine card in previous seasons, please do so here

Consent*

I agree to the waiver of liability

I, the parent/guardian registering my child[ren] for a Mindful Sports program, am aware that participation in youth sports programs has some inherent risks and injury can occur. On rare occasions these injuries can be serious. In consideration of my child[ren] being allowed to participate in Mindful Sports programs, I, the parent/guardian, assume the risk of participation and agree not to hold Mindful Sports, the program directors, coaches, assistant coaches, or owner responsible for any and all injuries caused by or resulting from participating in Mindful Sports Programs. I understand that this program is taking place during a time when Coronavirus presents additional risk. I understand these risks. In the event of any injury or illness caused directly or indirectly by Coronavirus or any such virus, I will not hold Mindful Sports, and all associated parties previously mentioned, responsible. By selecting the "I agree" button above, I state that I understand this description and agree.

Consent

I agree to the permission for photographic likeness

I, the parent/guardian registering my child[ren] for a Mindful Sports program, authorize the use of pictures of the above-named child participant to be posted on the Mindful Sports website or advertising media published by Mindful Sports

Credit Card

Card Details

Cardholder Name

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Spring Camp 2023 Form

June 8th-9th DOE Camps

Spring After-School Families ONLY (Same Weekday Registration)