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  • Student Information

  • Parent/Guardian Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Emergency Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Informed Consent and Liability Waiver


    I give permission for my child to participate in activities, classes, workshops, camps, outings, and related programs organized by Jenny T. I understand that participation may involve certain risks, including but not limited to physical activity, travel between locations, outdoor activities, and use of art materials and equipment.

    I voluntarily assume all risks associated with participation and release, waive, and hold harmless Jenny T., its instructors, assistants, volunteers, affiliates, and property owners from any and all claims, liabilities, damages, injuries, or expenses that may arise from my child’s participation in these activities, except in cases of gross negligence or intentional misconduct.

    I understand that accidents and injuries can occur despite reasonable supervision and safety precautions.

  • Medical Authorization and Emergency Care


    In the event of an illness, injury, or medical emergency involving my child, I authorize Jenny T. and its staff, instructors, assistants, or representatives to obtain emergency medical care as deemed necessary.

    I authorize licensed medical professionals to provide medical treatment, emergency care, diagnostic procedures, and other necessary treatment for my child if I cannot be reached immediately.

    I understand that every reasonable effort will be made to contact me or my emergency contact as quickly as possible in the event of an emergency.

    I accept responsibility for any medical expenses incurred as a result of emergency treatment.

  • Transportation and Walking Permission

  • I give permission for my child to participate in supervised walking activities, transportation between activity locations, outdoor classes, and off-site activities related to the program, including activities in public spaces, parks, trails, downtown areas, and nature-based environments.
  • Photo and Media Release

  • I grant permission for photographs or videos of my child participating in activities to be used by Jenny T. for promotional, educational, website, and social media purposes.
  • I give permission for my child to participate in walking activities from Natural History Institute to locations around Downtown Prescott as part of the summer camp program.
  • I give permission for my child to be transported by an authorized adult driver in a personal vehicle from BASIS Prescott to the Natural History Institute, and as needed for program-related activities. I understand that transportation by vehicle involves inherent risks, including but not limited to traffic accidents, road conditions, and other unforeseen circumstances.
  • Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

    In consideration for allowing my child to participate in the walking and transportation activities described above, I hereby release, waive, discharge, and covenant not to sue the organizers, staff, volunteers, and drivers associated with the summer camp program for any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by my child while participating in such activities.

    I understand that these activities involve certain risks, including but not limited to: 

    • Walking risks: trip hazards, uneven terrain, and encounters with vehicles or pedestrians
    • Transportation risks: vehicle accidents, sudden stops, traffic conditions, and other roadway hazards

    I voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including death, that may be sustained by my child as a result of participating in these activities.

    REFUNDS

    Unfortunatly we are not able to give refunds.

  • Choose Your Session*

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    Session 1: Art and Soles | Monday - Friday at Natural History Institute : June 1-5. Art and Soles Summer Camp with Mrs. T and Mrs. Nardo! A creative mix of art, games, movement and more. 9 a.m. to 2 p.m.
    Session 1: Art and Soles | Monday - Friday at Natural History Institute : June 1-5

    Art and Soles Summer Camp with Mrs. T and Mrs. Nardo! A creative mix of art, games, movement and more. 9 a.m. to 2 p.m. 

    $375.00$375.00
      
    Session 2: Art and Soles | Monday - Friday at Natural History Institute : June 8-12. Art and Soles Summer Camp with Mrs. T and Mrs. Nardo! A creative mix of art, games, movement and more. 9 a.m. to 2 p.m.
    Session 2: Art and Soles | Monday - Friday at Natural History Institute : June 8-12

    Art and Soles Summer Camp with Mrs. T and Mrs. Nardo! A creative mix of art, games, movement and more. 9 a.m. to 2 p.m.

    $375.00$375.00
      
    Session 4: Art and Soles | Monday - Friday at Natural History Institute : July 6-12. Art and Soles Summer Camp with Mrs. T and Mrs. Nardo! A creative mix of art, games, movement and more. 9 a.m. to 2 p.m.
    Session 4: Art and Soles | Monday - Friday at Natural History Institute : July 6-12

    Art and Soles Summer Camp with Mrs. T and Mrs. Nardo! A creative mix of art, games, movement and more. 9 a.m. to 2 p.m.

    $375.00$375.00
      
    Total
    $0.00$0.00
  • Date
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