Register After School Fall 2020 Private Pod

How many children are you registering?*
Participant 1
Participant 1 Name*
First Last
Participant 1 Date of Birth*
Date Format: MM slash DD slash YYYY
Participant 1 Grade*
grade entering in the fall
Participant 1 Allergies
Participant 1 Other Information
Other Important information we should know about your child.
Participant 2
Participant 2 Name*
First Last
Participant 2 Date of Birth*
Date Format: MM slash DD slash YYYY
Participant 2 Grade*
grade entering in the fall
Participant 2 Allergies
Participant 2 Other Information
Other Important information we should know about your child.
Participant 3
Participant 3 Name*
First Last
Participant 3 Date of Birth*
Date Format: MM slash DD slash YYYY
Participant 3 Grade*
grade entering in the fall
Participant 3 Allergies
Participant 3 Other Information
Other Important information we should know about your child.

Parent Name*
First Last
Parent Email*
Parent Emergency Phone Contact*
Billing Address*
Street Address Address Line 2 City State ZIP Code
In consideration of participation in this program, I hereby indemnify and hold harmless and release, Run for Fun Camps, the Run for Fun Coaching staff, the City of Palo Alto, its agents, its employees, and volunteers working for the city of any and all liability for injury or sickness suffered by myself or my child arising from or connected with this program. I assume all risk for any injuries. I understand that Run for Fun Camps will follow Santa Clara County Directives for youth programs during our camp offerings, but even with that in mind there is a possibility campers can contract Coronavirus at Run for Fun Camps. I release Run for Fun Camps for COVID 19 related symptoms that may be contracted by my camper during the after school camps. I sign of my own free will.
Parent/Guardian Signature*
Date*
Date Format: MM slash DD slash YYYY

Participant 1 Pod Information
Pod Members
Please list the children you wish in your pod.
Location of Pod
Participant 2 Pod Information
Pod Members
Please list the children you wish in your pod.
Location of Pod
Participant 3 Pod Information
Pod Members
Please list the children you wish in your pod.
Location of Pod
Total Cost and Payment
Cost*

Please enter the agreed upon price for this pod
Coupon
Office Use
Total
$0.00
We encourage you to pay online as there is no additional fee for paying via credit card. If you are unable to, please email us at info@runforfuncamps.com to discuss sending a check. All payments must be received before a spot is reserved. Payment plans are available please contact us
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Participant 1