SUMMER CAMP REGISTRATION FORM & WAIVER 

Every student that registers MUST have a registration form and waiver submitted (One form is fine for multiple siblings and if you are attending multiple camps).  Parents must fill out complete form and sign the waiver. 

Please copy and paste the forms, sign, and either scan and email to minimonetny@gmail.com or bring the first day of camp.  All campers must have forms handed in in order to attend camps

STUDENT NAME__________________________________________________

CLASS(S) ATTENDING_______________________________________________

AGE_____________

Grade ____________

Parent Name ____________________________________________________

Phone____________________________

Address_______________________________________

Email_________________________________________

Emergency Contact (other than registering parent)____________________________________________

Emergency Contact Phone________________________________________

Allergies_________________________________________________________________________________

Any other medical conditions or any other pertinent information______________________________________________________________

_____________________________________________________________________________________________________________________

SNACK & ALLERGY POLICY

We are a nut free studio. Students will need to bring in a  nut free lunch (for 3 hour camps). No food for 2 hour camps. Please include water bottle!

CANCELLATION & REFUND POLICY

Payment must be paid in full at time of registration. No refunds allowed. You may cancel your registration and receive a STORE CREDIT if we receive notice at least one week before the camp starts. Once a camp has started then no refunds, studio credit or makeups will be issued. You may transfer your spot to another student though. If you do not show up to camp and do not let us know, your registration sadly cannot be refunded. We put a lot of thought and energy into each class and prepare for each spot.

Parents will drop off outside the studio. Once class begins, our doors will be locked. For camps that are 3 hours, students will bring a bagged lunch and water bottle. 2 hour camps students will bring a water bottle. We will be bringing students for half hour lunch break (3 hour camps) and may bring outside for 15 minute break for 2 hour camps unless inclement weather.​

ASSUMPTION OF RISK 
I hereby acknowledge, agree, and accept the risk of injury inherent in any physical activity or program, including particularly, the activities offered by Mini Monet. Such risks may include but are not limited to falling, bumping, risks from abrasions, scrapes, cuts, broken, sprained or bruised limbs, choking, injury to eyes, consumption or inhalation of paint or other media, allergic reactions, as well as risks from the actions or omissions of others.

COVID-19

I acknowledge the contagious nature of COVID-19 and by signing this waiver hereby voluntarily assume the risk I or my child(ren) may be exposed to or infected by COVID-19 by attending a Mini Monet program, especially in light of the fact that the program may be attended by several other persons, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. 

I understand that COVID-19 risk may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Mini Monet employees, volunteers, and program participants and their families. I acknowledge that while Mini Monet will exercise reasonable care in avoiding unnecessary exposure, it is impossible for Mini Monet to screen and/or monitor all individuals, and that it relies in good faith on representations from parents and caregivers about their health and that of their children. I agree to inform Mini Monet of any health concerns or changes of individuals in my household while participating in activities at Mini Monet that could impact the risk to its staff or others. 

MEDICAL CONDITIONS / ALLERGIES

Mini Monet exercises reasonable care and precautions to minimize the risk of food-related allergic reactions during summer or holiday camp snack time, including implementing, communicating, & enforcing strict no-nut snack policies; however, Mini Monet does not in any way ensure that the risks are completely mitigated, nor does it assume liability for any food-related allergic reactions. We require all children who are prescribed an epi-pen, inhaler, diabetic monitor or other medical device carry it with them at all times while on the premises. Parents/Guardians assume full responsibility for their child's allergies and other medical conditions.

RELEASE OF LIABILITY 

I hereby release, discharge, indemnify and hold harmless Mini Monet, its owners, members, managers, instructors, affiliates, agents, employees, successors and assigns, from any and all injuries, illnesses, medical conditions, medical care, death, damages, claims, liabilities, expenses or judgments, including attorneys' fees and court costs resulting from my, my child(ren)'s, or my child(ren)'s caregiver's participation in a program or presence on Mini Monet's premises or other location where Mini Monet may conduct art instruction, except as such may arise out of Mini Monet's gross negligence, and including whether a COVID-19 infection occurs before, during, or after participation in any Mini Monet.

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I give permission for photos to be taken and used for posting on social media yes_____ no______

SIGNATURE OF PARENT__________________________________________________

PRINT NAME___________________________________________________

NAME OF CHILD ATTENDING_________________________________________

Date:____________________________

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122 & 128 Main Street

Sayville NY 11782

631-218-9797

​MiniMonetNY@gmail.com

Forms for AFTER SCHOOL CLASSES & SUMMER CAMPS

Mini Monet Art Studio