06/28/2022Events, NewsAbby Brown RM_StatsMontessori Summer Camp Registration and Medical Release (2022)Please submit one form for each camper you are registering.Email *Enter email again *Student First Name *Student Last Name *Camp week(s) you are registering forSelect an optionJuly 11-15 2022 ONLYGrade entering (Fall 2022) *Select an option1st2nd3rd4th5th6thSchool your child currently attends *Parent/Guardian Address Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Parent/Guardian Email(s) for camp correspondence *Parent/Guardian Name and Phone Number *Additional Parent/Guardian Name and Phone NumberPhysician Name and Phone Number *Current MedicationsAllergiesOtherI authorize HPMP, Helena School District, and its representatives to secure medical attention and care in the event of illness or accident for the above named child. In case of emergency, I understand that you will contact me as soon as possible. Permission is also granted to the doctor or the hospital and their associates to perform emergency medical and surgical procedures if needed.I also understand that photographs or other digital media may be used during summer camp to record the camp experience. I hereby allow HPMP to utilize photographs or digital media of my child for promotional summer camp materials such as brochures, presentations, or on the HPMP website.Parent Signature: Your name entered below will be considered your permission and understanding signature authorization. * Camp Selection and PaymentWhich camp(s) would you like to attend? *Select a payment method * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.