General Information  :  Activities  :   Tuition  :   Signup Form  :   Medical Form  :   Bus Transportation Form

Child's Name:
Male Female  Age:   Birth Date:

Child's Name:
Male Female  Age:   Birth Date:

Name of Parent/Guardian:
Permanent Address:
Required Email:
City:  State: Zip:

Permanent Home Phone:  Cell Phone:

Emergency Phone:   Summer Phone:

Family Dr's Name:  Telephone:
Insurance Plan Name:  Account Number:
Child Release Password (Anyone other than the parent or legal guardian must use this word to pick up a child in lieu of written permission.)
Please enroll my Child starting: (Fill in Dates)   To find your Child's group name, click here.
  Group Name #Days/ Week # Wks Start Date Full Day Half Day Tuition
1st Child
2nd Child
Check here to sign up for our Tennis Combo  
       $25 / week

Check here to sign up for our Water Sports Option  
      (See tuition chart for additional fee)

DEPOSIT AND REFUND POLICY
 A 50% deposit is due at the time of registration to reserve your child's space. Balance is due on or before May 31st. Cancellations received before May 31st will be refunded, minus $100 service fee. There are no refunds for cancellations received after May 31st. In the event of serious illness or accident during or before camp, a prorated refund will be given when accompanied by a physician's letter minus the $100 service fee.

As of June 1st, in the event the balance has not been received by this deadline, your child's space will be reduced to the amount of time equal to the deposit received only. This will be calculated from week one of camp. Refer to the tuition page for these amounts if necessary. There will be a $50 change fee applied.

A $50 service fee per family will be charged for changes made after we have received your registration.


TERMS AND CONDITIONS
Medical forms are due by June 28th regardless of your start date at camp.
~No refunds will be granted for sick or absent days.
~No children will be released to a non-family member without knowing the CHILD RELEASE PASSWORD you indicated on the previous page of the sign up form.
~The legal guardian(s) hereby gives approval and consent for the child's participation in the activities of The Art Farm.
~The legal guardian understands and certifies that his/her child's participation in the activities is completely voluntary and has familiarized himself/herself with the program and activities in which hazards and dangers are inherent. However, the Art Farm has taken safety measures to minimize the risk of injury to the participants.
~The Art Farm cannot insure or guarantee that the participants, equipment, premises and/or activities will be free of hazards, accidents and/or injuries.
~The child and legal guardian agree to abide b y the rules and regulations established by the Art Farm for the health, safety and welfare of the program.
~If necessary in the judgement of the program director, to use medical, surgical or dental aid for the child's health, the legal guardian hereby permits the program director to do so.
~All photos taken during the course of camp activities are the property of The Art Farm and can be used as deemed necessary."

I have read and fully understand the terms Above. Yes No
Signed:   Dated:

You will need to print this policy page and the sign-up form, and include both it with your deposit check.

Please make check payable to: The Art Farm • P.O. Box 1976 • Bridgehampton, NY 11932
Phone 631.537.1634 • Fax 631.537.2295