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Contact Person in Emergency if parents are unavailable:
1. I,, request that my child be admitted to BEE In The City. I understand that as
the parent/guardian submitting this registration form on behalf of the above named camper, that
I, alone, am responsible for payment of the camp fees in accordance with the following schedule:
$500 due at sign up, 50% of balance due by May 1st; final balance due in full by June 1st. After
June 1st, all camp fees are due in full at time of registration.
2. Payments can be made online via Venmo, Chase QuickPay or Google Wallet to BRIAN@BEEINMOTION.COM or via personal check made payable to BEE IN MOTION . Credit Card payment is available upon request.
3. I understand that ALL FORMS must be filled out, signed and returned with the Registration Form.
4. I give permission for my child to go on trips outside the camp facility via the form of walking, public
transportation, or bus.
5. I give my permission for my child to be included in camp photos, videos, or multimedia presentations
6. I give permission for my child's phone number and parent email address to be shared with other counselors
on a written list.
7. I certify that my child IS physically fit and has NOT been advised to NOT participate by a qualified medical
professional. I certify that there are NO health-related reasons or problems that preclude my participation in
this sports lesson. I acknowledge that this Accident Waiver and Release of Liability Form will be used by BIM for
all sports and activities in which I may participate and that it will govern my actions and responsibilities with
respect to BIM.
In consideration of my application and permitting me to participate in BITC summer camp sports training and
receive instruction, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors,
and assigns as follows:
I acknowledge that BITC sports, fitness activities carry with it the risk of death, serious injury, and
personal loss. These risks include, but are not limited to, those caused by terrain, facilities, temperature,
weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other
people including, but not limited to, participants, volunteers, spectators, coaches. I acknowledge that
engaging in sporting activity involves these and other inherent risks, and is a potentially hazardous
I agree that the laws of the State of New York govern this Waiver and Release contract and any dispute with BIM
or its Representatives. The Waiver and Release contract shall be construed broadly to provide a release and
waiver to maximum extent permissible under New York law, which allows a parent or guardian to execute a
release for a minor. I further agree that any dispute I have with BIM or its Representatives is subject to
mediation and, if necessary, binding arbitration, with the parties bearing their own costs. The arbitration will
apply the laws of the New York, take place in New York, and be conducted pursuant to the Commercial
Arbitration Rules of the American Arbitration Association. If any provision of this Waiver and Release contract is
held illegal or unenforceable, the remainder of this Waiver and Release shall remain binding.
I HAVE READ THE ABOVE WAIVER AND RELEASE, AND UNDERSTAND ITS CONTENT, INCLUDING THAT BY
SIGNING THIS AGREEMENT I AM WAIVING POTENTIAL LEGAL RIGHTS SUCH AS THE RIGHT TO SUE. I AM
AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT. I SIGN IT ON MY OWN FREE WILL.
Name, Relationship to Camper & Cell-Phone Number
**We will follow up to discuss these procedures**