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Sign up for week long Youth Workshop!
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Parent Name
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Last
Email
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Phone
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Should the Parent Above be the Primary Emergency Contact?
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Emergency Contact Name
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Last
Emergency Contact Relation to Participant
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Emergency Contact Phone Number
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Participant Name
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Participant Grade
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6th
7th
8th
Does Your Child Have Any Allergies or Medical Conditions?
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Yes
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List the Condition and What Treatment is Required
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Photo/Video Release
*
I hereby give permission for my child to be photographed and filmed during the North Andover CAM July 2025 Workshop. I understand the photos will be used to keep a journal of activities, to share during powerpoint presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspapers, on the Internet and on our cable access station. I understand that although my child’s photograph or video may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos and videos are the property of North Andover CAM and its affiliates.
Consent
*
North Andover CAM is not responsible for lost or damaged personal property. All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per physician orders. Children's photos and quotes may be used for publicity purposes. In case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. EMT, First Responder, and/or Physician).
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July 2025 Workshop
Monday July 21st to Friday July 25th 9:00 a.m. to 2:00 p.m.
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