Winter Camp Registration Form

Please fill out this form to enroll in our Winter Camp. A $100 non-refundable deposit is necessary to hold your spot. Payment must be made in full by December 20th. Payments can be made over the phone, or in the office. The payment amount remains the same within the Winter camp regardless of changes in teacher, class structure, program, illness, absence, vacation, or any other reason your child may miss class. After payment is made there will be no refunds unless WSMC can't host the program.

Child's Full Name

Child's Age

Child's Date of Birth

Guardian's Full Name

Emergency Contact Phone Number

Additional Phone Number

Contact Email

Address

Please add the name and contact info for your child's Primary Health Care Provider

Medical Treatment Release. Are we allowed to:

Does your child have any allergies?

I want to subscribe to the mailing list.

Hold Harmless

The FRP(s) agrees to release and hold harmless WSMC, its employees, trustees, and agents from all claims, damages or other liabilities for injuries to their child which are not the result of gross negligence by WSMC, its employees, trustees, and agents. The FRP(s) also agrees to pay WSMC for any damages or loss caused by their child to the School or School property. The School is not responsible for damage to or theft of personal property.

I agree to the terms & conditions.

Your Signature

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