Summer Camps 2023 (Central Park)

Childs First Name *

Last Name *

Date of Birth * +

Home Phone Number *

Street Address *

Zip Code *

Cross Streets, ie between which streets, aves *

School *

'23-'24 Grade *

Parent #1 Name *

Parent #1 Cell *

Parent #1 Email Address *

Parent #2 Name

Parent #2 Cell

Parent #2 Email Address

Emergency Contact Name & Phone # 🛈

Full day is 11AM-3PM and is $125 per day or $500 for the full week

Half day is 11AM-1PM and is $60 per day or $250 for the full week

Step One Select Your Week or Weeks

Please Choose *

Week 1 (6/12-6/16)

Week 2 (6/19-6/23)

Step Two Select Your Days or Full Week

Please Choose *

Step Three Select Full Day or Half Day

Please Select One *

Full Day

Half Day

__________________________________________________

Credit Card Type

Name on Card

Credit Card Number

Expiration Date (mm/yy)

CVA Code

Billing Zip if different

Notes:

A $20 registration fee will ba added to all registrations.

Submission of this registration form serves as your agreement to the COVID waiver, click here.

As parent or legal guardian of the above applicant, I hereby consent to his/her participation in any and all activities in Manhattan Athletics and agree to abide by all rules and regulations of the institution. In consideration of Manhattan Athletics accepting this registration and permitting the participation of above applicant, which I believe would be of educational, physical and other benefits; I assume all risks and hazards incidental in participation in all activities. I hereby release, discharge, indemnify and harmless Manhattan Athletics, its officials, coaches, representatives and all persons transporting my child/dependent to and from activities from any and all claims, actions and liability arising out of or in connection with my child’s participation in any aspect of Manhattan Athletics, whether or not such injury is caused by the negligence, willful conduct or other inaction of the indemnities or any of them. I certify that he/she is in good health and able to participate in all activities and in the case of emergency affecting my child, I hereby give permission for a physician or hospital designated by Manhattan Athletics to administer treatment to my child. I also understand that Manhattan Athletics has a no refund, no credit policy for any reason at any time for any programs unless Manhattan Athletics is unable to deliver the program. If your player decides after the first 2 sessions that the program is not working, we will credit the prorated fees.

Please note that a $50.00 processing fee will be charged for any cancellation of registration prior to the start date. We are a nut/peanut free program, please comply!