AeroCamp 2015 Camp Information

Transcription

1 AeroCamp 2015 Camp Information Old Bridge Flight School is offering Aviation Camp (AeroCamp) for children ages 10 through 18. The program will run from Monday July 6 through Friday July 10, 2015, 09:00 A.M. until 3:00 P.M. at the Old Bridge Airport located at 182 Pension Road, Gate #4, Englishtown, NJ REGISTRATION The following pages contain the registration form and all medical paperwork to be filled out. Be sure to fill these out and mail/ /or bring them in with the deposit as soon as possible in order to secure a spot for your child. All registrations will be processed on a first come first serve basis. PAYMENT A $150 deposit is required to hold a camper s reservation. The tuition balance is due by the first day of camp. The cost of tuition includes all project materials, snacks, lunch, water bottle and t-shirt. Checks can be made payable to Old Bridge Flight School and sent to the Old Bridge Flight School AeroCamp, 182 Pension Road, Englishtown, NJ CANCELLATIONS/REFUNDS Request for cancellation must be received in writing. No refunds can be given if the request for cancellation is received less than 7 days prior to camp date start. Please allow 7days for refunds to be processed. CAMP STAFF The staff at Old Bridge Flight School includes 2-3 instructors with many years of aviation and teaching experience. In addition, there will be an AeroCamp director, and an assistant director. One of the two camp directors will be present at all times and campers will be supervised throughout the day. We take our business and the care and safety of every child very seriously. ADDITIONAL INFORMATION Camp is conducted at Old Bridge Airport (3N6). Check-in for all camps begins at 9:00 A.M. Campers must be picked up promptly at 4:00 P.M. For any additional information, visit the website or contact us at

2 CAMPER S INFORMATION AeroCamp 2015 Enrollment Application First Name Last Name Home Address City State Zip Age Gender Date of Birth School Grad (Fall 2015) AeroCamp: Basic Advanced T-Shirt Size: Youth L Adult XS Adult S Adult M Adult L Adult XL PARENT / GUARDIAN INFORMATION First Name Last Name Home Address City State Zip Daytime Phone Evening Phone Cell Phone If paying by check make check payable to: Old Bridge Flight School, LLC. Check # Check Amount $ Credit Card: Visa/MasterCard Number ****Credit Card payment can be made via telephone to the Old Bridge Flight School at

3 AeroCamp 2015 MEDICAL INFORMATION AND RELEASE AEROCAMP PARTICIPANT (please complete in blue or black ink) Name Address Last First MI Street City State Zip Date of Birth mm/dd/yyyy Health Insurance Carrier: Policy Number: Group Number: Personal Physician: Physician Address (Physician): Street City State Zip Phone Number Fax Number PARENT, LEGAL GUARDIAN, OR OTHER PERSON WHO HAS LEGAL AUTHORITY TO AUTHORIZE MEDICAL TREATMENT TO PARTICIPANT IN CASE OF EMERGENCY, PLEASE CONTACT: Name: Relation: Address: Street City State Zip

4 Home Phone : Work: Cell List any chronic or acute or any other relevant medical problems and explain: List any allergies to pollen, food or medicine: List any medications presently being taken: I acknowledge that the participants immunizations are current: yes no My child or dependent plans to attend the Old Bridge Flight School s AeroCamp, hereinafter referred to as camp. In case of accident or illness, I give permission to receive medical treatment as deemed appropriate. I will assume responsibility for any medical billing. Adult participant or parent/legal guardian signature Date Please print camper s name Print parent s name

5 AeroCamp 2015 CODE OF CONDUCT Camp is designed for the enjoyment and benefit of all campers Involved. With this as the objective, we anticipate that no camper attends involuntarily. Should any disciplinary problems occur, we will contact the parent/guardian and ask that the camper be taken home. Please read and sign the AeroCamp code of conduct. 1. Please keep hands and feet to yourself. 2. Respect other campers, instructors, employees and property. 3. Please DO NOT bring any items of value to camp, or any of the following items: ipods, hand held video games, chewing gum, or any other distracting items. Physical aggression, continued disrespect, or continued disruption of camp activities will result in camper being sent home immediately. No refunds will be given to camper(s) who are sent home for disciplinary issues. Campers sent home for disciplinary action may not be eligible for future camps. I have read and understand the AeroCamp Code of Conduct and agree to its terms. Signature of Parent/Guardian Date Camper Signature Date

6 Hold Harmless Your signature on this form indicates that you wave certain legal rights. Read carefully before signing. Minor s Name: Date of Birth: Date of AeroCamp 6 July -10 July 2015 I hereby represent that I am the parent or legal guardian of Participant who is under the age of 18. For and in consideration of Old Bridge Flight School, LLC permitting participant to participate voluntarily in a Old Bridge Flight School LLC AeroCamp to be held on 6 July thru 10 July, at Old Bridge Flight School LLC., located at the Old Bridge Airport in Englishtown, New Jersey hereafter referred to as AeroCamp. I hereby assume all risks associated with the AeroCamp and release Old Bridge Flight School, LLC, its trustees, employees, students, and agents from all claims, demands, suits, causes of action, or judgments which participant or I ever had, now have, or may have in the future or which our heirs, executors, administrators, or assigns may have, or claim to have against Old Bridge Flight School, LLC or its trustees, employees, students, and agents, arising out of or in any way connected to the AeroCamp for all personal injuries, known or unknown, property damages, or claims for wrongful death, caused by the acts, omissions or negligence or old Bridge Flight School, LLC. or its trustees, employees, students, and agents. I further agree to indemnify and hold harmless Old Bridge Flight School, LLC., its trustees, officers, employees, students, and agents from all claims, demands, suits, causes of action, or judgment which participant or I ever had, now have, or may have in the future or which our heirs, executors or administrators, if assigns may have or claim to have against Old Bridge Flight School, LLC., its trustees, officers, employees, students, or agents arising out of or in any way connected with the AeroCamp. All personal injuries, known or unknown, property damage (including lost or stolen property), or claims for wrongful death caused by the acts, omission, or neglect of Old Bridge Flight School, LLC., its trustees, officers, employees, students, or agents, and on Old Bridge Flight School, LLC and in Old Bridge Flight School, LLC name defend at my own expense any such claims, demands, suits, causes of action or judgments described above. I also agree to be responsible for any property damage or personal injuries that participant or I may cause intentional or negligent acts while participating in the AeroCamp. Parent/Guardian Signature Date Parent/Guardian Print