Event Registration

2019 Math Camp Fitness
06/08/2019 09:30 AM - 06/29/2019 01:30 PM CST

Parent/Guardian Information

Please complete the following information for the parent/gurardian of the student attendee.

Waiver Statement:


PHOTOGRAPH CONSENT WAIVER: I understand that Jewels Academy may photograph my child individually or in a group setting. I understand that photos may be used in brochures, websites, newspapers, presentations, and television spots to further publicize the mission of the organization. I give full consent for these and similar uses of my child's photographic likeness, waiving any liability for Jewels Academy's Y.E.S. or its directors or employees. Choose YES for consent to take pictures or No to exclude your child from any pictures.


 EMERGENCY MEDICAL AUTHORIZATION:  I understand that in the event of accident or illness, every effort will be made to contact parent/guardian immediately.  If parent/guardian cannot be reached, I authorize Jewels Academy to obtain emergency care for my child.  Type parent's name below.

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