Summer Registration

Summer Camp Registration

  • Your Information

  • Emergency Contacts

  • Authorized to Pick Up

    The following individuals are authorized by parent(s)/guardian(s) to pick child up from EYC Art Camp:
  • Media/Publicity Release

    I give EYC Academy permission to audio, video, and photograph my child while participating at EYC Academy for the purposes of EYC Academy or any funder supporting the camp or activity without expectation of compensation or approval rights (i.e. brochure mailings, highlight promotional videos and photos for our website or social media).
  • Medical Release

    The health and history are correct so far as I know, and the person described has permission to engage in all prescribed camp activities except as noted. In case of a medical emergency, if I (parent/guardian listed above) cannot be contacted, I hereby give permission to a camp representative to seek emergency treatment, including transportation by emergency vehicles. I further understand that every effort will be made to contact the camper's responsible parent or guardian. I authorize this form to be copied for emergency purposes. I further understand that if I do not have medical insurance that covers ALL costs, I will be responsible for such medical and travel expenses.
  • Waiver of Liability

    In consideration of being permitted to participate in any way in the activities at and to attend EYC Academy, I, for myself, my child, my heirs, personal representatives or assignors, do hereby release, waive, discharge, and enter a covenant not to bring legal action against EYC Academy, its officers, employees and agents, from liability from any and all claims including the negligence EYC Academy, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to the activities and attendance at any camps or services at EYC Academy. The participation in activities at EYC Academy carries with it certain inherent risks that cannot be anticipated or eliminated regardless of the care taken to avoid injuries. Activities at EYC Academy's camps require a low level of physical fitness. I warrant that my child is physically fit and able to participate in all activities. I also agree to INDEMNIFY AND HOLD HARMLESS EYC Academy, its officers, employees, and agents from any and all claims, actions suits, procedures, costs, expenses, damages and liabilities, including attorney's fees, as a result of my child's attendance and involvement in any activities while at EYC Academy, including any claim asserted by my child after he/she becomes an adult. I also acknowledge that I have read the above and understand that I am giving up substantial rights, including the right to sue. I acknowledge that I am signing freely and voluntarily and intend by my signature to a complete and unconditional release of all liability to the greatest extent allowed by law.

Empowering Youth and Communities, Inc. dba EYC Academy, does not and shall not discriminate in its educational programs or activities on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status. These activities include, but are not limited to, hiring and releasing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all.

Empowering Youth and Communities dba EYC Academy is an equal opportunity/affirmative action employer. We will not discriminate and will take affirmative action measures to ensure against discrimination in employment, recruitment, advertisements for employment, compensation, termination, upgrading, promotions, and other conditions of employment against any employee or job applicant on the bases of race, color, gender, national origin, age, religion, creed, disability, veteran’s status, sexual orientation, gender identity or gender expression. We will comply with state and federal laws such as M.G.L. c. 151B, Title IX, Title VI and Title VII of the Civil Rights Act, the Americans with Disabilities Act, Section 503 and 504 of the Rehabilitation Act of 1973, the Age Discrimination in Employment Act, the Vietnam Era Veterans Readjustment and Rights Act, Executive Order 11246 and other similar laws that prohibit discrimination, all as amended.