Summer Immersion Registration | BetterWorldLanguages

Please make sure to fill out one form per child !

Parent Guardian First Name

Parent Guardian Last Name

Address

Email

Phone Number

Student's First and Last Name

Student's Date of Birth

Camp of Choice

Session 1: Beginner Spanish Mornings July 20th- July 24th 9am- 12pm

Session 2: Beginner Spanish Mornings August 10th- August 14th 9am- 12pm

Names and phone numbers of persons allowed to pick up child

Allergies or Medical Conditions

Medical Consent ( Confirmation Checkbox (Required):

In the event of an emergency, I authorize BetterWorld Language's staff to secure necessary medical treatment for my child.

Medications

Emergency Contact Name,Phone Number, and Relationship to Student (list all)

Liability Waiver ( Confirmation Checkbox (Required)

I agree to release and hold harmless the camp, its employees, volunteers, and partners from any and all liability.

Media Release

I give permission for my child to be photographed or video recorded for promotional purposes.

I do not give permission for my child to be photographed or video recorded.

Any special needs/requests ?

I understand that each program is limited to 10 students. Registration is handled on a first-come, first-served basis, and we cannot guarantee specific class times or dates. Early registration and reservation payment are required to secure your preferred spot.

Signature ( Parent/Guardian)

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By typing my name above, I confirm this serves as my digital signature and consent to all statements in this form.

Summer Immersion Registration Form