Summer 2024 Specialty Music Camp Registration Summer Day Camp Registration Camp / Child Information There is an option to add additional children below. Child’s Name * Last * Current Age * Birth Month * JanFebMarAprMayJunJulAugSepOctNovDec Birth Day * 12345678910111213141516171819202122232425262728293031 Birth Year * 2020201920182017201620152014201320122011 Please select ALL camps THIS child is registering for: * (Ages 4-6) Kinder-Music Camp (July 8-12) (Ages 4-6) Kinder-Music Camp (July 15-19) (Ages 6-12) Musical Theatre Camp – Ms. Rachel (July 15-19) Do you need after care for any of the weeks? * Yes No AFTER CARE (4:00 PM to 5:00 PM MONDAY to THURSDAY) July 8-11 July 15-18 Please note After Care is NOT available Friday. Total Is this child a current student at Orrett Music Academy? * Yes No Health Information It is our policy to contact the parent or guardian as soon as possible in the event of an accident, injury, or in case the child is not feeling well. If the information has changed on the day of registration, please speak to the camp counsellor. Please bring all medication in the ORIGINAL CONTAINER or you will not be allowed to leave the medication or vitamins at the camp. All prescriptions must be in that child’s name and in the correct dosage. All fields are required below. If nothing applies, please put “NO” in the box. Any activity(ies) the camper should be restricted from? * Any physical, health, or other condition(s) that we should be aware of and would require special attention or medication while at camp? * List any past medical treatment(s) that would be helpful for us to know. * List any allergies (ex: bees, peanuts, dairy, shellfish). * Please pack a water bottle, nut-free lunch and 2 snacks daily for your child, however, are there any dietary needs that we should know about? * OPTIONAL – Use this section to include comments such as: activities the child enjoys, what they are looking forward to, and any additional information you think would be helpful. While our planning needs to consider all campers, we will do our best to keep all comments in mind. plus1 Add Child minus1 Next Parent/Guardian Information Parent/Guardian’s Name * First Parent/Guardian’s Last Name * Last Phone * Email * Confirm Email * Re-type email to confirm OPTIONAL – Secondary Parent/Guardian’s Name First Secondary Parent/Guardian’s Last Name Last Secondary Phone Secondary Email Confirm Secondary Email Re-type email How did you hear about us? Currently a studentImmediate family member of a current studentInternet searchSignInstagram ADFacebookReferralOther Kindly specify Who referred you? Emergency Contact If parent or guardian is not available. Emergency Contact Name * First & Last Emergency Phone * Emergency Contact Relationship * Release of Child(ren) Please list anyone, including YOU as the parent/guardian, to whom your child(ren) can be released. * Please let us know if there are any changes POLICIES SCREEN TIME At Orrett, we pride ourselves in providing interactive activities and keeping screen time to a minimum. Unless screen time is required for educational purposes, Orrett camps have NO screen time during a typical day unless outdoor activities cannot take place due to inclement weather or a parent/camper declining to take part. PERSONAL PROPERTY Orrett Music Academy does not assume any responsibility for personal property (including, but not limited to clothing, cameras, cell phones, purses, wallets, vehicles, etc.) lost, damaged, or left unattended on school premises, in common areas, or in the parking lot behind the building. REFUNDS Withdrawal from camp may be done up to 30 days prior to the first day of camp, in which case all fees will be refunded minus a $50 administrative fee. No refunds will be provided with less than 30 days’ notice prior to the first day of camp. TERMINATION OF ENROLMENT Orrett Music Academy reserves the right to cancel the enrolment of any student/family for reasons of disruptive behaviour, inappropriate conduct by the student and/or parent, frequent absences, late payment, or other reasons at the sole discretion of Orrett Music Academy. In such rare cases, remaining tuition (if applicable) will be refunded and an administrative fee of $50 would apply. AUTHORIZATION By signing and clicking submit, you agree that you are the parent or legal guardian of the above-named camper, and are over the age of 18. I certify that my child(ren) has my permission to attend Orrett Music Academy’s summer camp program and to participate in all activities (unless I specified above). I also acknowledge that I may receive e-mails from Orrett Music Academy. Policy Acknowledgement * I have read and I acknowledge Orrett Music Academy’s camp policies regarding Screen Time, Personal Property, Refunds, Termination of Enrolment, and Authorization. Camp Payment Information Total Method of Payment * I am not a current Orrett student and would like to provide a credit card Credit card ON FILE (this only applies to current students) Payment * Payment Payment Payment Month 123456789101112 Payment Year 20242025202620272028202920302031203220332034 Payment Does Orrett Music Academy have authorization to charge your credit card for the amount indicated above * Yes Please allow up to 10 business days for credit card processing. Please continue to next page to review information carefully. Scroll to the bottom of the page to verify and DON’T FORGET TO CLICK SUBMIT!
