EYA Summer Camp

EYA Summer Camp

Please provide your details and consent to participate in the summer camp.
Parent/Guardian Full Name

First NameLast Name
Child's Full Name

First NameLast Name
School Name
Child's Age
Current Grade
Academic Areas of Concern
Shirt Size
Medical Needs & Allergy DisclosureDoes your child have any known allergies (food, bee stings, environmental), medical conditions, or specific medication needs that our staff should be aware of for this trip?Please include if your child will be carrying an inhaler or EpiPen, and provide clear instructions for use. If there are no medical needs or allergies, please type "NONE".
Photo & Video ReleasePhoto / Video Release | I give permission for Edison Youth Activities to photograph and/or record my child during EYA Summer camp activities. These images or videos may be used for promotional purposes, including social media, flyers, websites, and other marketing materials.I understand that no compensation will be provided and that all media remains the property of Edison Youth Activities.
Liability Waiver & Emergency AuthorizationI, the parent/legal guardian of the participant, hereby give my permission for my child to participate in the EYA Summer Camp program and all related activities and field trips. I agree to release and hold harmless Edison Youth Activities, its officers, employees, and volunteers from any and all liability, claims, or causes of action arising out of my child’s participation.In the event of an emergency, I authorize EYA staff to obtain necessary medical treatment for my child if I cannot be reached.
Parent/Guardian Signature
Should be Empty: