Summer By the Sea Registration

  • Learn More About Our Summer Program

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  • Registration Form

    Child's first name

    Child's last name

    Date of birth

    school attended this year

    Parent Name 1

    Parent Name 2

    Best number to reach you

    Your Email (required)

    Other number

    Your Address

    Please select the sessions

    07/10 - 07/14
    07/17 - 07/21
    07/24 - 07/28
    07/31 - 08/04
    08/07 - 08/11
    08/14 - 08/18

    Please select your schedule

    Monday Full DayMorningAfternoon
    Tuesday Full DayMorningAfternoon
    Wednesday Full DayMorningAfternoon
    Thursday Full DayMorningAfternoon
    Friday Full DayMorningAfternoon

    Please indicate if your child has any allergies or health concerns:

    Emergency/pick-up 1 name & number:

    (present valid I.D for pick-up)

    Emergency/pick-up 2 name & number:

    (present valid I.D for pick-up)

    Child Permission on/off site activities & field trips:
    I hereby grant permission for my child to use all of the play equipment and participate in all of the activities of the school, and to leave the school premises under the supervision of a staff member for neighborhood walks or field trips in an authorized vehicle.

    I hereby grant permission for the Director or Acting Director to take whatever steps may be necessary to obtain emergency medical care. These steps may include, but are not limited to, the following:

    1-Attempt to contact a parent or guardian, the child’s physician, or the persons listed on the emergency information form.
    2-If we cannot contact you or your child’s physician we will do one or both of the following: (a) call another physician or paramedics (b) have the child taken to an emergency hospital in the company of a staff member.
    3-Any expenses incurred under 2, above, will be the child’s family’s responsibility.
    4-The school will not be responsible for anything that may happen as a result of false information given at the time of enrollment.

    Initial(required):

    PARENTS’ CONSENT FOR EMERGENCY MEDICAL TREATMENT:

    As the parent or legal guardian, I hereby give consent to Ecole Claire Fontaine to provide all emergency, dental or medical care prescribed by a dully-licensed physician (M.D) osteopath (D.O.) or dentist (D.D.S) for my child.This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent. This authorization is given pursuant to the provision of Sec. 25.8 of the Civil Code of California and in no event will Ecole Claire Fontaine, its officers, leaders, or agents be held liable for any first aid or surgical treatment or procedures performed pursuant to this consent. If the incident is minor, Arnica Montana 6ch Homeopathic remedy will be administered to accelerate healing and calm inflammation.

    Initial(required):

    PHOTOGRAPHY, VIDEO, AUDIO RELEASE FORM:
    Dear Parents and Guardians:
    As you know, when your child takes lessons or participates in events at Ecole Claire Fontaine, it often creates great photo opportunities. We would like your permission to publish these photographs/video/audio recordings on our website, newsletters, social media blogs, yearbooks, etc. to illustrate learning activities in our facility.
    We encourage you to follow the links on our website to Facebook, Youtube or our Blog, so you can see how we use these videos/audios and recordings to share and inspire, you can also consult previous yearbooks in our office. All media will be available for parents to review upon request and full names and tags will not be attached. Please review the photograph/video/audio consent options below and choose one box that best represents your request regarding the use of photographs/videos/audio recordings of your child by ECF. Thank you.

    I GIVE Ecole Claire Fontaine permission to use my child’s image/photograph/video to illustrate educational activities in printed publications social media or website. I hereby release and discharge ECF from any claims arising out of the uses of the photographs/videos that my child may appear in.
    Initial(required):

    PAYMENT INFORMATION:
    I hereby give consent to ECF to charge my credit card for any outstanding balances
    * All program fees & payments are non-refundable.

    Please note, there is a $96.50 Students Registration Fee payable with Dwolla, Paypal, in our office OR by mail.

    Please indicate payment method:

    You may also visit or call our office to pay by check or credit card. Merci!
    signature(required):

    Note