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City of Huntsville

formssubmissions@huntsvilleal.gov

308 Fountain Circle Southwest, Huntsville, AL, 35801, US


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Spring Break Camp Registration

March 13-17, 2023

Full-day & specialty camp options

Open to Huntsville City Schools students

Grades 1-6 

 

Address

Date of Birth

Parent/Guardian Name(s)


Emergency Contact (other than parents) 

Name

Please List Who Is Authorized To Pick Up Your Child

Authorized Person One

Full Name

Authorized Person Two (optional) 

Full Name

Authorized Person Three (optional) 

Full Name


Is your child under a doctor's care or taking medication?

By signing below I acknowledge that I have reviewed the Code of Conduct with my child(ren) and agree to the following:

Dropoff/Pickup Procedures: Campers must be accompanied into the building by a parent or guardian to be signed in each day. Parents/guardians must also enter the building to sign out the child at pickup. Children may NOT sign themselves into or out of camp.

Late Pickup Policy: In the event of a late pickup, a parent/guardian should call the staff as soon as possible. Staff are not permitted to transport children home under any circumstances. If a parent/guardian is more than 30 minutes late and has not contacted the staff supervisor, police may be called to assist the child.

Medical Treatment: As a parent or legal guardian of the above-named participant, I hereby give my consent for emergency medical care prescribed by a licensed Doctor of Medicine, Doctor of Dentistry or Emergency Medical Technician/Paramedic. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of my dependent.

Medication Policy: Emergency medication such as an inhaler, EpiPen or diabetic injections are permitted. These must be clearly labeled with the participant’s name and directions for administering the drug.

Staff will NOT administer medication. Please make sure that any medical conditions, allergies, or physical limitations are listed on this registration form and communicated to staff prior to participation. All other medications should be administered at home.

Behavior: As a parent or legal guardian of the above-named participant, I understand that my dependent may be dismissed from the program for disciplinary reasons at any time without recourse or refund.

Damages: In consideration of you accepting my child’s entry, I hereby, for myself, my child, my heirs, executors and administrators, waiver and release all rights and claims for damages I or my child may have against the City of Huntsville and its representatives, successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by the City of Huntsville Parks and Recreation Department.

Photo Release: I hereby authorize the City of Huntsville, Alabama to publish and use my child’s name and/or my child’s likeness (“Likeness”) for the promotion publicity, advertising, or other manner or media by the City of Huntsville (the “City”) Department of Parks and Recreation or any other representative authorized to act on behalf of the City. A full copy of the waiver can be obtained at the recreation center’s front desk.

Fees:

The fee for Day Camps is $50 per student and $30 for each additional child. Payment must be made at the recreation center prior to the start of camp.

The fee for Specialty Camps is $25 per student and $10 for each additional child. Payment must be made at the recreation center prior to the start of camp.

Code of Conduct:

  • No weapons allowed on the property
  • No profanity or fighting is allowed (seek staff for intervention)
  • No using or possession of tobacco products, vapes, or alcoholic beverages
  • No vandalism of property  
  • No running in the hallways
  • No sagging pants
  • No hats or bandannas inside the facility
  • No food, drinks, or candy in gyms or computer labs
  • Do not leave the facility unless you are with staff or your parent/guardian

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