MISA HYLTON FASHION ACADEMY

CAMP

Misa Hylton Fashion Academy

116 west 23rd Street, 5th floor

New York, NY 10001

 

T. 646.580.MHFA

F. 646.607.4430

Male Female
 
www.misahyltonfashionacademy.com

Misa Hylton Fashion Academy

116 west 23rd Street, 5th floor

New York, NY 10001

 

T. 646.580.MHFA

F. 646.607.4430

This form is to be filled out by the parent/guardian of the camper. This medical history MUST be completely filled out and returned with your child’s registration.

Male Female
Health History: (Check box if applicable and use line to explain)
Allergies
Hyper/Hypotension
Asthma
Medications Taken
Bleeding/Clotting Disorder
Mononucleosis
Diabetes
Operations/Injuries
Dietary Restrictions
Physical Limitations
Disabilities/Chronic Illness
Psychiatric Treatment
Frequent Ear Infections
Seizure Disorders
Heart Defect/Disease
Other
yes no

IMPORTANT: PARENT/GUARDIAN MUST SIGN

I hereby give permission for camp medical staff to provide routine treatment to my child. I understand that I am responsible for my child’s medical or medication needs and further agree that in an emergency and/or if I cannot be reached, Misa Hylton Fashion Academy, through its agents and employees, may take whatever action is determined necessary with respect to my child’s health and safety. I authorize the Misa Hylton Fashion Academy, its agents and employees, to place my child, at their discretion and without further consent, in a hospital or in the care of a medical services and treatment, and to arrange necessary related transportation for me and/or my child. I understand that I will be fully responsible for any fees and expenses for any service and/or treatment. This completed form may be photocopied for off campus trips.

www.misahyltonfashionacademy.com

Misa Hylton Fashion Academy

116 west 23rd Street, 5th floor

New York, NY 10001

 

T. 646.580.MHFA

F. 646.607.4430

Summer Camp Registration Agreement

By registering my child(ren) to attend MHFA Summer Camps 2017 (“Camp”), I agree to the following terms and conditions:

  • I am the parent or legal guardian of the child(ren) being registered.
  • A nonrefundable deposit of $250 per session, paid by check or credit card, must accompany this registration form.
  • We accept Visa, MasterCard, American Express, bank check, or money order. No personal checks accepted after July 1, 2017. Cash is never accepted.
  • Payment in full for all camp sessions is due by June 15, 2017. Any registrations received after June 15, 2017, must be paid in full immediately.
  • No refunds after July 1, 2017, for any reason, including illness, injury, personal matters, missed days, transportation delays, etc.
  • MHFA reserves the right to cancel any registrations if tuition is not paid in full by July 1, 2017.
  • I give permission for my child to participate in a off‐campus trip/activity, I understand that scheduled off‐campus trip destinations may change due to weather conditions or administrative needs.
  • In consideration of my child being allowed to participate in Camp, on behalf of my child, myself and my family, I hereby release and agree to hold MHFA, its trustees, directors, officers, employees, servants, representatives and agents harmless from and against any and all claims, losses, damages, expenses (including attorneys’ fees, and all court and litigation costs) and liability (including statutory liability), resulting from injury of any person or damage to or loss of any property arising out of or in any way connected with the Camp and my child’s participation therein.
  • I agree that photographs, whether still or action, videos, film and/or motion pictures (hereinafter “Pictures”), and/or audio recordings (“Recordings”), may be taken of my child by or on behalf of MHFA and in connection with Camp, and, without any compensation or further notification or approval by me or my child, grant to MHFA, its agents, employees, and others working on MHFA’s behalf (“MHFA”) the unlimited, perpetual, worldwide, unconditional and irrevocable right and license to use, distribute, publish, exhibit, digitize, broadcast, display, reproduce, make commercial use of and otherwise use directly or indirectly the Pictures, Recordings and/or my child’s image, voice, likeness and/or video footage in any form, format or media (“Media”), for any purpose, including, but not limited to, advertising or trade or MHFA-related activity in promoting or providing information about MHFA and its educational and summer camp services and agree that all rights therein shall irrevocably, exclusively, unconditionally and perpetually belong to MHFA.

I have read and agree to the above:

REGISTRATION WILL NOT BE PROCESSED WITHOUT A SIGNATURE

Payment Options

Check Credit Card
www.misahyltonfashionacademy.com