2020 Virtual Summer Camp Elementary Application 2020 Virtual Summer Camp Elementary Application Child's Name:* First Last Child's Date of Birth:* Does your child attend Hudson Montessori School?*YesNoWill your child attend Hudson Montessori School in September?*YesNoWhich school does your child attend?*Age as of 6/29/2020:*Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mother's Name* First Last Mother's Phone:*Mother's Email Address* Enter Email Confirm Email Father's Name:* First Last Father's Phone:*Father's Email Address:* Summer Camp Photo/Video Waiver:Consent:*I consentI do not consentI give my permission to have my child's photo or video taken while participating Hudson Montessori School Zoom activities. I understand that these images may be used for projects, newsletters, our school website, social media and other Hudson Montessori School related publications, and are the sole property of the school.Hours & Camp WeeksBY COMPLETING AND SUBMITTING THIS SIGNED APPLICATION, AN AGREEMENT IS MADE BY THE PARENT WITH HUDSON MONTESSORI SCHOOL TO HAVE YOUR CHILD ENROLLED FOR THE ENTIRETY OF THE CAMP WEEK(S) INDICATED IN THE APPLICATION. PARENTS ARE RESPONSIBLE FOR FULL PAYMENT OF THE CAMP WEEK(S) IN WHICH THEIR CHILD IS ENROLLED. ALL PAYMENTS ARE NON-REFUNDABLE.Full Summer Camp Fee Payment*Upon submission of this application, you will receive an email with instructions for payment through our payment service provider, FACTS. I understand by submitting this application, the summer camp fee must be made within 1-2 business days after receiving the account setup instructions. In addition, I understand that my child's registration will only be confirmed once full payment is received for summer camp. I AgreeFull Summer Camp Fee Payment*I understand by submitting this application, the summer camp fee will be scheduled for payment on my FACTs account within the next 1-2 business days. In addition, I understand that my child's registration will only be confirmed once full payment is received for summer camp. I AgreePlease list the name of the parent/guardian who will make the summer camp payment.*Which week(s) are you interested in? (Press Ctrl+Mouse Click to select multiple sessions):*Week 1 (6/29-7/3)Week 2 (7/6-7/10)Week 3 (7/13-7/17)Week 4 (7/20-7/24)Week 5 (7/27-7/31)Week 6 (8/3-8/7)Hours:*9:00-4:009:00-12:001:00-4:00Additional Comments:Signature*Date:* This iframe contains the logic required to handle Ajax powered Gravity Forms.