STEMCity Consent And Release Form

I hereby authorize my child’s participation in all Columbia Grammar and Middle School STEM Camp activities. I recognize that the field trips may require strenuous physical activity and I attest that my child is physically fit for such activity. I, as the parent, assume all the risks normal to these activities and absolve Columbia Grammar and Middle School STEM Camp of all present and future liability in the event of accident or injury. In the event of an accident or sudden illness, if Columbia Grammar and Middle School STEM Camp cannot reach me by phone, I authorize them to arrange for emergency medical care for my child.

Further, I irrevocably grant to Columbia Grammar and Middle School STEM Camp the right to use any photograph, likeness, or image of my minor child, and/or me and my family in whole or in part, in any media, including the Internet, for promotional or other purposes provided that my minor child(ren)’s last name(s) and/or my last name and my family’s last names shall not be used to identify my minor child(ren)’s, and/or me and my family in any such photograph, likeness or image in whole or in part. I release Columbia Grammar and Middle School STEM Camp from any liability in connection with such use.

If you choose to not have your child(ren)’s images used, please email STEMCity@cgps.org

I acknowledge that I have read this Consent and Release Agreement and that it shall benefit and be binding on me, my successors, heirs and assigns.

Also, I have read and agree to abide by the following policies:

There is a $250 cancellation fee for Columbia Grammar and Middle School STEM Camp withdrawals. Requests for refunds must be received in writing at least one week prior to the camp start date. After these dates, there will be no refunds for any Camp cancellations.

There is a $30 charge for returned checks. We assume no liability for clothing or other personal belongings left unattended.