GMG 2019 Summer Camp Consent & Release Form

This form give us important information such as allergies and whether or not the camp participant will need early drop off / after care /and lunch.
Please note we're unable to fulfill laptop loaner requests made after June 20.

Participant Information

Contact Information

Summer Camp Services

Is the participant attending on scholarship/financial aid?
This will impact your invoice for summer camp services

Medical Information

Does the camper have any allergies? *

End of Day Release Authorization

Photo & Video Release

Your child could be part of our promotional campaign or a press event!

Girls Make Games staff may take and use photos and or videos of participants for publicity purposes.
Photos and videos of our participants may be used on the Girls Make Games website, LearnDistrict website, Facebook, Twitter other media, e-newsletters and any other publications.
Consent *

Parent Permission and Signature

Consent *
Parent/Guardian Signature *