Chester County Night School

Summer Camp Registration - Chester County Night School


Thank you for enrolling your child in Chester County Night Schools (CCNS) Amazing Race Summer Camp. We are very excited about all of the fun activities that we have planned for the summer. Our goal is to offer a camp designed to challenge youth to explore the world through education, sports, field trips, team building and recreation. If you have any questions, do not hesitate to contact the CCNS office at 610-692-1964 To submit your form:

  1. Enter the requested information shown on this form.
  2. After entering the information, print a copy for your records.
  3. Click the Submit button. You will receive system email notification of a successful submission, and will be returned to this page should you want to submit additional proposals.


** IMPORTANT! BEFORE YOU PROCEED **

Click Here to see Frequently Asked Questions and Other Important Information

Camper Information *Indicates required field


Parent Information

Emergency Contact Please list at least two people we may contact in case of an emergency and we are unable to reach you (must be 18 yrs or older)


Permission for Pick-up If applicable, please list anyone, other than yourself, who has permission to pick up your child (ID may be required).


Campers' Medical Information

Medications If applicable, please list any medicine that your child has permission to take during camp. (Write NONE if they don't need to take medication) Please indicate if they need assistance taking the medication from one of our staff members. "Medication is any substance a person takes to maintain and/or improve their health." We require that all medications are in the original pharmacy container with the camper's name.


Waiver and Agreement ATTENTION: PLEASE READ THE FOLLOWING CAREFULLY. THIS WAIVER AFFECTS YOUR LEGAL RIGHTS

In consideration of my/my child's participation in the activities of the CCNS, I agree to waive, release, indemnify and hold harmless CCNS and its respective officers, employees, volunteers, and members for injuries, accidents and damages that result from my child's participation in the programs including but not limited to liability for its own negligence, and do hereby on behalf of myself, heirs, executors and administrators, waive, release and forever discharge any and all rights and claims for damages which may have or which may hereafter accrue to me/my child arising out of or connected with participation in the programs, use of the CCNS facilities and property, or use of equipment within its facilities and property. I understand that even when every reasonable precaution is taken, accidents can sometimes occur. I further understand that the activities of CCNS have inherent risks and I hereby assume all risks and hazards incidental to my or my family's participation in programs or use of the facilities, or equipment within its facilities. I also understand that:

In the event that I cannot be reached in an emergency, I authorize the CCNS staff to provide and obtain medical treat treatments for my child.

I give permission for CCNS to transport my child to and from program activities.

CCNS is not responsible for lost or stolen property.

Picking up my child after the designated pick-up time will result in a charge of $5 for every 15 minutes of lateness.

By typing my name below, I accept the above terms in their entirety. Please type your name below. This serves as your signature and authorization of all information on this form.

Before you submit the form, please print a copy for your records.

Thank you for your interest in Chester County Night School!

Click the Cancel button to cancel the summer camp form and return to the home page.