Fontbonne Hall Academy

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FHA The Summer Camp for Girls 2020 Registration Form

Thank you for your interest in attending Fontbonne Hall Academy's Summer Camp for Girls 2020! 

Please fill out the registration form below. 

July 6th - July 31st  Monday - Thursday 9am - 5pm  Fridays 9am-1pm

Early drop off and late pick up available 

All Four Weeks - $2500

Per Week - $725

Checks made out to Fontbonne Hall Academy:

Fontbonne Hall Academy

9901 Shore Road

Brooklyn, Ny 11209

Non-Refundable Registration

Registration Open December 16

Registration Fee $50 April 1st 

 

Early Registration Fee $25 -March 2nd

Non-Refundable Deposits Due April 15th 

 

All Four Weeks- $450

Per Week- $150

Final Payments Due May 1st 

 

Summer Camp Schedule

9:15 -10:30 - Sports and Activities

10:45 - 11:00 Morning Snack

11:05 - 12:15  Class 1

12:20 - 1:00 Lunch

1:05 - 2:15 - Class 2

2:20 - 3:35 Activity 1

 

3:40 - 4:55 Activity 2

Student Information

Address
State*
Answer Required

Parent/Guardian Contact Information

Weeks Attending. Check off the week(s) that you will be attending*
Answer Required
Rank in order the activities you are interested in (1 most interested-7 least interested)
Answer Required
1
2
3
4
5
6
7
Drama
Art
Broadcast journalism
Dance
Chess
Fab Lab
Cooking

Medical Information & Consent Forms

Please read and fill out all the information below. 

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by during the selected camp. In exchange for the acceptance of said child’s candidacy by FHA Summer Camp, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless . and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against . including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death

Child & Adolescent Health Examination 

FHA Summer Camp for Girls requires each camper to have a physical examination and immunization history provided by a physician within 12 months of attending camp. This form must be submitted, reviewed, and approved  before a child may begin any camp program. Forms are due no later than May 1 to allow for timely review. After May 1, any camper who does not have an approved health form on file will be placed on medical hold and risks losing his or her placement to a camper on our waitlist. Form can be accessed below. 

Medical Release and Authorization
As Parent and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
Permission is also granted to FHA Summer Camp and its affiliates including Directors, Coaches,Teachers, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.
Release authorized on the dates and/or duration of the registered season.
This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.