Camper Name *
* Birthdate *
Grade Entering in the fall 2017 * 6th Grade 7th Grade 8th Grade 9th Grade T-Shirt Size * Adult Small Adult Medium Adult Large Adult XL Adult XXL Insurance Information *
Insurance ID Number
Any known food allergies Any concerns Parent/Guardian Name *
Phone * Email *
I agree to the following disclaimer *
The enrolled student has my permission to take part in the BEA Career Exploration Camps during the summer of 2017. I hereby release, absolve, and discharge Genesee County BEA (Business Education Alliance), Genesee Valley Educational Partnership, and their representatives, employees, and agents (hereinafter “Camp providers”) from any claim arising from my child’s participation in BEA Summer Career Exploration Camps. In the event of an emergency, I acknowledge that the Camp providers will attempt to reach me at the address and telephone number provided on the registration to obtain my consent to medical treatment, if necessary. However, by operation of this permission document, I authorize the Camp providers to obtain expedient and proper treatment to assure the health and well-being if my child. I acknowledge and agree that I will be responsible for any medical expenses, which may be incurred as a result of an accident or injury during the All About Dogs Camp beyond routine first aid expenses. I understand that Camp providers are not responsible for any loss or damage to a participating student’s possessions or property during the Camp. By signing this agreement with Genesee County BEA, you are allowing your child to be photographed or permit other persons to photograph for the purposes of: news releases and/or public relations to include: story boards, brochures, any other informational purposes in the promotion of the BEA.