Registration 2020

2020 Camp Courant Virtual Registration Form

  • Personal Information

    (At least one phone number is required; please notify office of any changes)
  • Camper Information

    (One registration form is required for each camper)
  • Date Format: MM slash DD slash YYYY
  • Camp Courant is open to children of Hartford between the ages of 5-12.
  • In an effort to obtain grants and keep Camp Courant FREE, we report on the following below:

    (Responses are for reporting purposes only and do not determine enrolment.)
  • Free/Federal Reduced Lunch
  • Please Answer the Following Questions

  • Hartford's Camp Courant Virtual Standard Release Form

  • I hereby request that my child be enrolled as a “virtual” camper at Camp Courant, Inc. As an enrolled camper, I give permission for my child to voluntarily participate in Camp activities, which I have familiarized myself with, including, but not limited to, sports, physical fitness, arts & crafts, swimming, nature walks, table games and recreational activities (except those noted on the ‘Camper Health Record’ and ‘Authorization for the Administration of Medications and/or Blood Glucose Test’ forms). I understand that Camp Courant, Inc. is not responsible for the supervision of my child during the virtual Camp day, and that the Camp is merely providing programming for my child. I will remain responsible for supervising my child at all times while participating in programming provided by Camp Courant.

    I certify that the information listed on the ‘Camper Health Record’ and ‘Authorization for the Administration of Medications and/or Blood Glucose Test’ forms are accurate, and my child has no undisclosed medical or other condition(s) that might affect his or her ability to participate in the activities above. I affirm that I have identified any/all medical restrictions my child may have. I understand that I will be responsible for administering all medications for my child while participating in the virtual Camp day.

    I further understand and recognize that certain hazards and dangers are inherent in the events and programs offered to campers at Camp Courant, Inc., including virtual activities. These potentially hazardous and dangerous activities include, but are not limited to sports and physical fitness activities that may be a part of the virtual Camp. I understand that Camp Courant, Inc. has taken safety measures to minimize the risk of injury to Camp participants when participating in physical activities as a part of the virtual Camp, but cannot ensure campers will be free from accidents or injuries. I agree that I am responsible for supervising my child while engaged in any virtual Camp activities, including physical activities, and that the Camp does not have any responsibility to supervise my child,

    With a full understanding of the above-mentioned risks, I agree to release and hold harmless Camp Courant, Inc. and its agents, officers, employees, representatives, from any and all liability, claims, suits, demands, judgments, costs, interests and expenses (including attorney’s fees and costs) for any other loss, damage or injury, including those caused by negligence, that may occur during my child’s participation at Camp, including participation in any activities, programs, events, vision and dental screenings, transportation or field trips.

    I agree that I have thoroughly read the entire registration package, and reviewed all rules, regulations and procedures with my child.

    I understand that prevention and health awareness programs, including discussions about Acquired Immune Deficiency Syndrome (AIDS), will be part of the curriculum for the 9-12 year olds.

    I also agree that all photographs, videos, negatives, prints, paintings, drawings, sketches, reproductions and likenesses of any kind made of the child while participating in the virtual Camp are and shall remain the property of Camp Courant, Inc., its successors, and assigns. I give my irrevocable consent that said works, or any part thereof, may be published, displayed, reproduced, and circulated in any form by Camp Courant, Inc. or anyone else authorized by Camp Courant, Inc. with or without the child’s name, for commercial purposes or otherwise, including advertisement in any media, and with or without any testimonial copy of other form of advertising or display.

    In order for my child to be considered for admission to Hartford’s Camp Courant this summer, I have completed all the necessary information and signed release form.

    I further acknowledge that my child will receive a weekly “school in a box” that may include both learning materials and food for my child. I understand that all aspects of the Program, including “school in the box,” have risk, including the possible transmission of COVID-19. Therefore, I understand that the activities associated with the Program present risks to my child personally and to his property, some of which may result in serious physical injury or death, and that these risks can be consequence of not only my child’s actions or negligence but also the actions or negligence of others, including third parties.

  • Date Format: MM slash DD slash YYYY
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