Summer Camp Registration

Register and pay for LCCS Summer Camps using the form below. Please complete a separate form for each camper.

Required

Parent/Guardian 1 Namerequired
First Name
Last Name

Parent/Guardian 2 Name
First Name
Last Name

Student Namerequired
First Name
Last Name
Grade student will enter this fall.
In which camp(s) will the student participate?required
Does the student have any allergies or medical conditions?required

In addition to parents/guardians listed above.

In consideration for the opportunity to participate in any LCCS Summer Camp, the Participant (or parent/guardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in the activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury sustained during the activity. Further, the Participant (or parent/guardian) promises to indemnify, defend, and hold harmless the activity sponsor, or its agents, employees, volunteers, and any other representative (collectively referred to hereinafter as “Sponsor”) for any injury related directly or indirectly out of the described activity, unless such injury arises out of the gross negligence of the Sponsor or otherwise. If a dispute over the agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the Participant (or parent/guardian) and the Sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel of the American Arbitration Association for the final resolution.

Permission to Treat

I hereby give permission for my student to be treated at LCCS as necessary. If a parent cannot be notified and emergency care is needed, I hereby give permission for my student to be treated or transported to the nearest hospital, and I give permission for the hospital to give emergency treatment as needed. I will assume responsibility of fees incurred by such an emergency.​​

I understand the above statement and give LCCS permission to treat my student.required
Photo Release
 
I give LCCS permission to use photographs of my child in summer camp promotional materials including, but not limited to, website and social media.​
I understand the above statement and give LCCS permission to photograph my student.required
Waiver of Liability and Assumption of Risk Related to COVID-19
 
By attending LCCS summer camps, you agree to abide by the COVID-19 procedures established by LCCS to protect campers and staff, and you voluntarily assume the risk that your child and/or your family may be exposed to or infected by COVID-19. You agree to assume all the risks of attendance and participation for you and your family, and you waive any liability against LCCS and any other parties.
This electronic signature is treated by LCCS like a physical, handwritten signature on a paper form.
$95 per camp. (50% off for children of LCCS employees.)

Payment Information

Please select a payment typerequired
Billing Addressrequired
Cardholder Namerequired
Expirationrequired