2019_APV_Summer_Registration

REMINDER: If you register for a week and your child does NOT attend you will be charged a $15 penalty fee, please choose weeks accordingly as we staff the camp based on registrations!

PAY NOW

**Credit card payments will NOT be accepted at camp, they must be paid by using our quickpay link above.

VENMO NOW ACCEPTED - Search for Joanna Crews or @opmi-lessons

CASH APP NOW ACCEPTED - Joanna Crews or $opmimusic

2019 APV Summer Camp Registration Form

Please note that all fields followed by an asterisk must be filled in.

Parent/Guardian First Name*

Parent/Guardian Last Name*

E-Mail Address*

Street Address*

City*

State/Prov*

Zip/Postal Code*

Cell Phone*

Camper's Name*

Age *

School

Please list ADA Accommodations needed

Single Day Camper-Please specify Date

Extended Day Hours 6:30am-7:00pm (Additional $20/week)*

	YES, I wish to sign my child up for the extended camp hours
	NO, I do not wish to sign my child up for the extended camp hours

Approved Child Pick Up (Provide first and last name)*

Emergency Contacts (provide first/last name, relation to child and phone number)*

Do you authorize OPMI to use photos of your child on our website and/or promotional material?

	YES
	NO

Payment FOR WEEK ONE due by May 31st - Payment Type (payments are due each Friday before camp starts)

	Check
	Cash/Venmo
	Online

Statement of Understanding*

By checking this box I accept and understand that there are 10 weeks of OPMI Summer Camp ($70/per week) beginning June 3rd - August 9th. Summer Day camp hours are from 8:00am-6:00pm, Extended drop off and pick up are from 6:30am-8:00am and 6:00pm-7:00pm which has an additional cost of $20 per child per week. For a single summer day camp registration (drop off/pick up) the daily fee is $35.00. There will be a onetime registration fee of $20 upon the first week of summer camp sign up. Any portion of the camp that my child cannot attend shall be forfeited without refund or credit. If you register for a week and your child does NOT attend you will be responsible for paying a $15 penalty, we staff camp based on registrations so please choose weeks accordingly and if you need to cancel a week please give us a week notice.

Statement of Understanding*

I also understand that I am responsible for picking up my child from camp on time. If I am more than 10 minutes late, I accept and understand that fees will be applied. I also understand that any belongings I send my child to camp with are the responsibility of my child and OPMI nor the Association of Poinciana Villages is responsible for lost, damaged, or stolen items.

LIABILITY WAIVER*

BY CHECKING THIS BOX, I AGREE THAT I HAVE READ AND VOLUNTARILY SIGNED THIS AGREEMENT ELECTRONICALLY and further agree that no oral representation, statements, or inducement apart from the following written agreement has been made: IN CONSIDERATION, of being permitted to utilize the facilities, services and program of ORLANDO PREMIER MUSIC INSTRUCTION, herein after referred to as 'OPMI', for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any off-site program affiliated with OPMI, the undersigned, for himself or herself and any personal representatives, heirs, children and next of kin, hereby acknowledges, agrees and represents that he or she releases OPMI and its staff members from all liability for an injury, loss or damage connected in any way whatsoever to participation in OPMI activities whether on or off of the premises affiliated with OPMI. He or she understands that this release includes any claims based on negligen

Special Needs/Concerns:

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2019 APV Summer Camp Registration Form

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