My Chinese Tree House
After-School Fees & Info
Rules & Guidelines
MCTH Late Pick-up Policy
2018 Summer Camp
9th Annual Summer Camp
My Chinese TreeHouse After-School Program Waiver
I, the under signed parent/guardian of
*(Type in Student's Full Name)
do hereby consent to his/her participation in "My Chinese TreeHouse"
I acknowledge that participation in this camp may expose the above named student to the possibility of injury. I grant "My Chinese TreeHouse"
Staff the authority to obtain emergency medical treatment as necessary to insure that the above named
is safe from further injury.
In consideration of "My Chinese TreeHouse" allowing this
to participate in its
, I agree to waive and release "My Chinese TreeHouse" from all claims for damages that may arise, other than by negligence of "My Chinese TreeHouse", its employees and agents, as a result of my child’s participation in its
I am aware that the above named
may appear in a photograph, or video, taken by
staff or local media and that photograph or video may appear in a variety of media sources on behalf of "My Chinese TreeHouse". "My Chinese TreeHouse" will not divulge your child(ren)’s name without written permission.
I acknowledge that the above named
may be participating in activities, trips and events organized by "My Chinese TreeHouse". I am aware that the participation of my
may be outside the scope of his/her daily routine. I give permission for my child to travel by foot, automobile, or bus to a desired location.
*I acknowledge and confirm that I have read this entire After-School Program Waiver and consent to it, prior to typing my full name below. (Parent/Guardian's full name)
*After-School Program Code Word (must match registration)
PLEASE PRINT A BLANK HARD COPY FOR YOUR RECORDS