SUMMER CAMP 2019 REGISTRATION Please fill out a registration form for each camper that you are enrolling and press the SUBMIT button. This will direct you to the PayPal page to pay for this registration. Parent/Guardian Name:*FirstLast Parent/Guardian Email:* Email confirmation:* Parent/Guardian Phone:* Mailing Address:* Address City State Zip Code Participants Name:*FirstLast Participant's Date of Birth (mm/dd/yyyy):* Please list any other information, concerns, allergies or health issues that we should be aware of to insure the best possible experience for your camper:CHOOSE CAMP SESSION(S) BELOW: •FULL AND HALF DAY SESSIONS AVAILABLE:• Morning: VIDEO PRODUCTION TV CAMP (9am-1pm)• Afternoon: VIDEO PRODUCTION MOVIE CAMP (1pm - 5pm) •COST PER WEEKLY SESSION: $275 half day / $480 full dayCAMPERS 7-11 YEARS OLD:CAMPERS 12-15 YEARS OLD: Week 1 - JUNE 10 - 14Week 1 - TV & MOVIE Camp - FULL DAYWeek 1 - TV Camp - Half Day MorningWeek 1 - MOVIE Camp - Half Day Afternoon Week 3 - JUNE 24 - 28Week 3 - TV & MOVIE Camp - FULL DAYWeek 3 - TV Camp - Half Day MorningWeek 3 - MOVIE Camp - Half Day Afternoon Week 5 - JULY 15 - 19Week 5 - TV & MOVIE Camp - FULL DAYWeek 5 - TV Camp - Half Day MorningWeek 5 - MOVIE Camp - Half Day Afternoon Week 7 - JULY 29 - AUG 2Week 7 - TV & MOVIE Camp - FULL DAYWeek 7 - TV Camp - Half Day MorningWeek 7 - MOVIE Camp - Half Day Afternoon Week 2 - JUNE 17 - 21Week 2 - TV & MOVIE Camp - FULL DAYWeek 2 - TV Camp - Half Day MorningWeek 2 - MOVIE Camp - Half Day Afternoon Week 4 - JULY 8 -12Week 4 - TV & MOVIE Camp - FULL DAYWeek 4 - TV Camp - Half Day MorningWeek 4 - MOVIE Camp - Half Day Afternoon Week 6 - JULY 22 - 26Week 6 - TV & MOVIE Camp - FULL DAYWeek 6 - TV Camp - Half Day MorningWeek 6 - MOVIE Camp - Half Day Afternoon Week 8 - AUG 5 - 9Week 8 - TV & MOVIE Camp - FULL DAYWeek 8 - TV Camp - Half Day MorningWeek 8 - MOVIE Camp - Half Day Afternoon TotalGENERAL INFORMATION:LOCATIONKCAT TV15 is located at Los Gatos High School – across from the swimming pool on Chicago Ave.EMAIL QUESTIONSinfo@kcat.orgWAITING LISTOnce a class is filled your name is automatically put on a waiting list.TRANSFER FEEParticipants may transfer to another camp 5 days ahead of the start of that program. A $10 transfer fee will apply per participant, per program.CANCELLATION FEESCancellations must be made 5 business days ahead of the camp. A $25 cancellation fee will apply per participant per camp. Cancellations made within 5 business days of the camp will receive a 50% refund per participant per camp. When enrollment is low KCAT TV15 reserves the right to cancel a camp. You will receive a full refund within 1 week.DISCLAIMERThe undersigned, in consideration of participation in the programs operated by KCAT TV15, agrees to indemnify and hold KCAT TV15, its Board of Directors, contractors, employees and volunteers harmless and release KCAT TV15, its Board of Directors, contractors, employees and volunteers from any and all liability for any injury which may be suffered by the named individual(s) registered in any program operated by KCAT TV15, arising out of, or in any way connected with participation in such program. I have read the above application and agreement, and fully understand that I assume all risks for any injuries received. Model Release: I release the videographer, photographer and KCAT TV15 from liability for any violation of any personal or proprietary right I have in connection with any reproduction of or use of video or photographs in which I appear. I consent to the reproduction or use of videos and photographs, without my name (except listed in show/movie credits), taken of me while participating in KCAT TV15 programs. KCAT TV15 and its videographer and photographer will only take photographs and videos in a public setting in which there is a reasonable expectation of privacy. This Waiver of Claims/Assumption of Risk/Consent applies to future participation in all programs of KCAT TV15 by all signatories and minors on whose behalf it has been signed. I have fully read this Agreement and fully understand its content. Furthermore, the significance of this release of liability and assumption of risk agreement has been EXPLAINED TO THE MINOR. I certify that I have custody or am the legal guardian of said minor and that I and/or my minor child are physically able to participate in recreation activities. In the event I or said minor requires medical treatment while under the supervision of staff and/or agents, I authorize said staff to provide and/or authorize medical treatment. I expect staff to contact me immediately in the event emergency medical treatment is required for said minor, but this contact is not necessary to administer emergency aid. I will pay for all medical treatment which I or said minor may require. I hereby grant permission to include pictures and/or video of me and/or said minor, while participating in KCAT TV15 program, for the TV channel, print materials, social media platforms, website, and YouTube.KCAT TV15 and its videographer and photographer will only take photographs and videos in a public setting in which there is a reasonable expectation of privacy. I understand I will not receive any compensation for use of such pictures or video. This Waiver of Claims/Assumption of Risk/Consent applies to future participation in all programs of KCAT TV15 by all signatories and minors on whose behalf it has been signed. I understand and agree to the terms and conditions of this registration and class as stated above. * I understand and agree to the terms and conditions of this registration and class as stated above. * reCAPTCHASubmitReset