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American Academy Casablanca
Summer Camp 2016 Registration Form
June 13th-July 1st
American Academy Casablanca
Casa Green Town Campus RN 3020, Ville Verte,
Bouskoura, Morocco 27182
Name of Student: _________________________________________________________ Date of Birth______/_____/______ Age: _____________ T-shirt size (child): ________ School student most recently attended: _________________________________________ My child speaks English. Yes / No Number of years studying English __________My child knows how to swim. Yes / No (All children must pass a swim test with the lifeguard before swimming at AAC)
Parent(s) or Legal Guardian(s):
Home Phone#: ____ - ___ - ___ - ___ - ___
Cell Phone#: ____ - ___ - ___ - ___ - ___
Email: __________________________________________________________ Emergency Contact: _______________________________________________________ Emergency Contact Phone Number: ____ - ___ - ___ - ___ - ___ Does your child use and inhaler for ASTHMA: Yes / NoDoes your child have any allergies? Yes / No
If yes, what are they?
Individuals authorized to pick my children up:
Parent/Guardian Signatures:_______________________ __________________________Date Signed:_______________________
The Registration Form is in
both English and French.Complete only One Version.
American Academy Casablanca
Summer Camp 2016 Registration Form
13 Juin -1er Juillet
American Academy Casablanca
Casa Green Town Campus
RN 3020, Ville Verte,
Bouskoura, Morocco 27182
Date de naissance______/_____/_____Age: _____________ Taille du T-shirt (enfant): ________ Dernière école fréquentée:_________________________________________Mon enfant parle Anglais : Oui / Non
Est ce que votre enfant sait nager Oui / Non
(Tous les eParent(s) ou Tuteurs:
Nom et Prénom de la Mère:__________________________________________________________ Nom et Prénom du Père: ____________________________________________________________Tel. fixe: ____ - ___ - ___ - ___ - ___
Mobile: ____ - ___ - ___ - ___ - ___
Email: __________________________________________________________ - ___ - ___ - ___ - ___ / Non Est ce que votre enfant a des allergies? Oui / NonSi oui lesquelles:
Personnes autorisées à récupérer mon enfant: Signature du Parent/Tuteur:_______________________ __________________________Date :_______________________
Medical Information
_________________________________ do hereby grant permission to American Academy Casablanca Summer School Faculty and Staff to authorize any necessary medical treatment and/or hospital care which is deemed necessary by trained medical personnel. Parent/Guardian Signature(s):______________________ ___________________________Date Signed:_______________________
Picture Policy
I give permission to the AAC summer program to publish any or all pictures of my child, ____________________________________________, taken during the duration of this program.Parent/Guardian Initials: _________ ________
Date Initialed:____________________
Transportation Liability
I understand that my child, __________________________________________, will be transported at times in the AAC summer program for field trips and other special circumstances. While enroute, the child will be under the direct supervision of the driver and nurse and will be subject to all
regulations set for the safety of the child. I will not hold the driver, American Academy summer program staff responsible for any injuries or loss of property which may be sustained as a direct or indirect result of this service. Parent/Guardian Signatures:_______________________ ___________________________