2020_SBW_Summer

STONEYBROOK WEST COMMUNITY

1201 Black Lake Blvd.

Winter Garden, FL 34787

EXTENDED CARE WILL BE PROVIDED FOR AN ADDITIONAL $45 per week, per child, per camp - those hours will be 8am-5pm.

**Because space is limited, a non-refundable $50 deposit per child/per camp will be required upon registration. The remaining camp payment will be due the week before the camp start date.

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Waterleigh Summer Camp Registration 2022

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*

Student's Name*

Age*

Rock Band - Phase 1 ClubHouse

July 25-29

*FOR ROCK BAND-YOU MAY CHOOSE 2 INSTRUMENTS YOU HAVE KNOWLEDGE OF (It is not a guarantee you will play these instruments)

	Acoustic Guitar
	Electric Guitar
	Bass
	Percussion
	Keyboard

*If enrolled in Rock Band, does your child have their own instrument they could bring from home? If so, what instrument?

FILM ACADEMY

August 1-5-LOCATED AT STONEYBROOK WEST TOWN CENTER

Are you signing up siblings?*

	YES
	NO

If you are signing up siblings, how many in total will participate?

Please list siblings names and ages

Please list ADA Accommodations needed

Please list any allergies

Transportation To and From Camp*

Approved Child Pick Up (Please list names, phone number and relation)*

Emergency Contact (Please list names, phone number and relation)*

Waterleigh Resident Verification *

By Checking this box, I acknowledge that I am a Waterleigh Resident. I Understand that Waterleigh Camps are only open to Waterleigh Residents and any registrations submitted by or for non Waterleigh Residents will not be permitted to attend camp.

OPMI Cancellation Policy*

A non-refundable $50 deposit per child/per camp is due at the time of registration. Remaining camp payments are due ONE week prior to each camp start date. To withdraw from a camp, notification must be made in writing 2 weeks prior to the start date of the camp or the remaining camp payment will be required.

OPMI Payment Policy*

If registrations are received after the camp registration deadline of 72 hours prior to the camp start date, I understand there will be an additional $25 late registration fee per child added to my camp payment due at the time of registration. I also understand that any portion of the camp that my child cannot attend shall be forfeited without refund or credit. Payments are due 1 week before camp starts, and any payments made after that are subject to a $25 late payment fee per child.

Statement of Understanding*

By checking this box I accept and understand that there are 10 different weeks of Summer Camp. Camp runs Monday - Friday from 9:00am-3:00pm unless otherwise notated, and extended camp hours are from 8:00am- 5:00pm. I understand that extended care is $50 per week per child; extended care fee is NOT prorated for amount of days my child needs extended care. Any portion of the camp that my child cannot attend shall be forfeited without refund or credit. 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 late pick-up fees will be applied.

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 negligenc

PROMO/DISOUNT CODE (If applicable)

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Waterleigh Summer Camp Registration 2022

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