Dawson Summer Camp Student Information Form

Student Camper Information
Parent/Guardian Information
Authorized Dismissal and Emergency Contacts (other than parents listed above)
General Health Information
This student's Physical Form and Immunization Record must be submitted before the student attends camp.
General Camp Policies
- Students must enroll for the full session. - Your registration will be complete when this form is submitted and the registration fee is paid. We will contact you immediately if the selected camp is no longer available. Detailed camp information and billing statements will be sent prior to each session. Please note that all sessions must be paid in full one week prior to the start of camp. Campers cannot attend a session until full payment is received. - Camp fee is refundable if written/email notice of cancellation is received two weeks before the start of a session. - Unacceptable conduct by a camper may result in dismissal without a refund. - The Dawson Summer Camp reserves the right to cancel any program that does not reach an acceptable enrollment level.
Consent to Emergency Medical Care and Treatment
If I cannot be reached, the emergency contacts listed above will be called. I authorize The Alexander Dawson School at Rainbow Mountain to call an ambulance to transport my child to a hospital or medical facility and to secure for my child the necessary medical treatment. Staff is trained in the basics of first aid and CPR and I authorize them to give my child first aid. In a center, any member of the staff responsible for the care and education of my child may view my child’s health information, as well as state licensors for compliance purposes.
Child Illness
If my child sustains a minor injury (e.g., scraped knee) during care, I understand that I will receive an Injury Report outlining the incident and course of action taken by the staff member when I arrive at pick up. I will be contacted immediately by the school staff if the injury produces any type of swelling or needs medical attention.
Assumption of Risk/Release of Liability Agreement and Consent to Emergency Medical Treatment (Minor Participants)
In consideration of my child’s participation in Dawson Summer Camp, on behalf of myself, my assigns and my heirs, expressly and knowingly agree to indemnify, defend and hold harmless the Board of Trustees of the Alexander Dawson Foundation, The Alexander Dawson School, it’s agents, it’s officers, employees and volunteers, (herein after “Sponsor”) for any and all claims, demands and/or causes of action for property damage, personal injury or death sustained by my child arising out of the Event conducted by or under the auspices of Sponsor, including, but not limited to, the selection and/or provision of emergency medical services. In consideration of my child being permitted by Sponsor to use its facilities and/or participate in Dawson Summer Camp, I agree to the following: I understand and agree that Sponsor cannot control all of the risks associated with Dawson Summer Camp, and may need to respond to accidents and other emergency situations. Therefore I hereby give my consent to the administration of any medical treatment that may be deemed by Sponsor to be required for my child relative to his/her participation, with the understanding that the costs of such treatment will be my sole responsibility. I agree to hold The Board of Trustees of the Alexander Dawson Foundation, The Alexander Dawson School, it’s agents, it’s officers, employees and volunteers harmless in all the costs associated with such treatment. I acknowledge that Sponsor does not carry medical or any other insurance for participants in Dawson Summer Camp. Therefore, I must provide my child with his/her own medical, disability or other appropriate insurance. By signing this Agreement, I acknowledge the inherent risks associated to my child for participating in Dawson Summer Camp and that such risks include, but are not limited to, the following: •Risk of physical injury, illness, accident or death in traveling to and from and participating in Dawson Summer Camp; Property loss, theft or damage; Exposure to dust, gas, fumes or chemicals; Tripping, falling or slipping; Problems related to exposure to the elements: for example, heat exhaustion, dehydration, sunburn, frostbite, and allergic reactions. I hereby certify that my child is in good physical and mental condition, and has no previous, or pre- existing medical conditions or injuries affecting his/her ability to participate in Dawson Summer Camp, nor has he/she been declared medically ineligible for any athletic competition. This Agreement contains the entire agreement between the parties and supersedes any prior written or oral agreements between them concerning Dawson Summer Camp. I have read the Agreement and have knowingly and willingly signed it with a full understanding of its purpose. I affirmatively represent that I am competent to execute this Agreement, intend to be bound by it, and agree that it shall be governed by the laws of the State of Nevada. I further understand that all incidences of noncompliance with any Dawson Summer Camp rules will result in my child’s dismissal from Dawson Summer Camp.
Type Full Name

The Alexander Dawson School

Welcome to The Alexander Dawson School at Rainbow Mountain! Located in Summerlin, a suburb of Las Vegas, Nevada, The Alexander Dawson School is a non-sectarian, non-profit school offering students in preschool through eighth grade an inspired and meaningful education. Students achieve their individual potential while savoring life and meeting the challenges of the world.