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SUMMER CAMP REGISTRATION FORM

2018 STEM SUMMER CAMP REGISTRATION FORM

Fields marked with an * are required

 

Please provide information requested in this form to complete the enrollment of your child.

 



Enter details for Child 1.

 


Enter details for Child 2 (if registered). If 2nd child is not registered, please fill N/A and 0.

 



MODEL RELEASE: I give permission to Nova Enrichment Academy, LLC, its agents, affiliates, and licensees to use photographs, reproductions, images or sound recordings of my child for advertising, publicity or any other lawful purpose.

 

LIABILITY WAIVER: In consideration of my child’s participation in the programs offered by Nova Enrichment Academy, including on-site events, I hereby release absolutely, forever discharge, and agree to hold harmless Nova Enrichment Academy, LLC, its agents, volunteers and affiliates, including contractors, other exhibitors, and speakers invited to the premises, from any and all liability, claims, demands, actions or rights of action, whether asserted by me or a third party arising out of my (or my child’s) participation any activities. I agree to indemnify and hold harmless the aforesaid parties from any costs associated with defending or litigating such claims, including but not limited to attorney fees, costs and legal expenses.