Molly Luhta - Soprano           Voice and Piano Teacher         OCCP Director

OCCP Summer Camp 2017

OCCP Summer Camp Registration Form
Camper Name
Camper Age
Parent/Guardian Name
Parent/Guardian Email Address
Parent/Guardian Primary Phone
Parent/Guardian Full Address
Emergency Contact
Does the camper have any allergies that we should be aware of?
Does the camper have an IEP at school?
Does the camper have any food allergies?
What level of swimming is the camper?
Is there anything else we should know about the camper?
If you answered 'Yes' to any of the above questions, please explain here
What size of t-shirt would the camper like?
Do you give your child permission to attend OCCP's Beach Day outing to Grass Creek Park, understanding that he/she may be driven by Molly or another parent volunteer?
Photo/Video Release: I hereby give permission for OCCP to take pictures and recordings of my child. This includes the right to use, exhibit, display, and/or broadcast the photographed/recorded images/sounds. I understand that the photos and recordings are intended for the activities and events in connection with OCCP.
Fees: I understand that cancellations made prior to April 1, 2018 will be refunded in full. No refunds will be given after March 31, 2018. I agree to pay for any dmamges that occur directly or indirectly by my child to music, instruments, or Emmanuel United Church property. Molly reserves the right to remove a child from OCCP Summer Camp 2018 at any given time.
Yes - I Agree
I understand that participation in the final concert on Friday, July 20, 2018 is mandatory for all campers. My child will be present at the concert.
Insurance Release: I understand and agree to the fact that OCCP Summer Camp 2018 is not privately insured, and wave liability for all injuries, damages, etc that occur directly or indirectly to/by my child.
I have read all information on this form and the information page. I agree to allow my child to participate in all OCCP Summer Camp activities, unless otherwise noted. I understand and agree with all that I have read.
Parent/Guardian Electronic Signature

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