Preschool Summer Camp Deposit

We are asking you to complete this form, stating the names of the individuals who are allowed to pick up your child from Kings Bay Y Preschool Summer Camp. Please be as thorough as possible with this list, as we will not allow your child to leave with anyone that isn’t named below. You may add additional names at a later time. Also, please be advised that the person picking up your child must have a valid form of photo ID on them, such as a driver’s license, a passport or current school issued ID. There will be NO exceptions.

I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or videotapes of the Student named above by Kings Bay Y.

I also grant Kings Bay Y the right to edit, use and reuse said products for nonprofit purposes including use in print, on the internet, and all other forms of media.

I also hereby release Kings Bay Y and its agents and employees from all claims, demands and liabilities, whatsoever in connection with the above.