After School Program Registration – Step 1. Fill Out Form


Email Address*




Parent First Name*

Parent Last Name*

Parent Phone Number*


Child First Name*

Child Last Name*

Child School*

CarnarvonHudsonNorma RoseQuesnelUniversity HillTrafalgar

Child Grade *

1234

Child T-Shirt Size *

SmallMediumLargeMy child already has an Ocean Explorer shirt and doesn't need another

Pick Up Information*

Child will be picked up by parent/guardianChild will leave by themselvesChild will be picked up by someone else(please indicate in the 'Pick Up Person Name')

Pick Up Person Name*

How did you find out about Sea Smart?*

Word of mouthYour child told you about Sea SmartSchool newsletterFlyerInternetSocial MediaNewspaperYour child has previously participated in a Sea Smart programOther...

Allergies or Medical Concerns*



Notes



I hereby approve my child's attendance in Sea Smart School Ltd's After School Program and certify that he/she is in good health and able to participate in the program activities. I give permission for staff to administer first aid treatment to my child, and acknowledge that I will be responsible for any medical or other charges in connection with my child’s treatment. I waive and release all rights and claims that arise out of traveling to, participating in, or returning from the program. I understand and am aware of the associated risks with participation within such a program. Sea Smart will occasionally take pictures and/or videos of its program participants to send to parents and for use in promotional materials. I agree to allow Sea Smart to reproduce the likeness of my child in such promotional materials. I agree to be sent information via email about Sea Smart's programs, including but not limited to photos and videos taken during the programs. I agree as a condition of my child’s participation in Sea Smart’s After School Program to assign to Sea Smart School Ltd ownership of any intellectual property produced by my child during Sea Smart’s After School Program. I understand that if I assign my child’s intellectual property rights to Sea Smart School Ltd, then Sea Smart School Ltd will manage the intellectual property and I will not receive any financial benefit from Sea Smart School Ltd for that intellectual property. Sea Smart’s payment terms are as follows: $50 Non-refundable registration fee is included in all program fees and will be deducted before any refunds are issued. 100% payment is required upon registration. All cancellations require email or phone notice and confirmation from Sea Smart at least 14 days before the program start date and will be issued a 50% refund (minus the registration fee). No refunds given for cancellations within 14 days before the program start date. Sea Smart reserves the right to cancel programs, with a full refund, if the minimum requirement of registration is not met. Sea Smart does not offer refunds or make up sessions for missed classes. Students who are disruptive, abusive or fail to follow in-class guidelines for conduct and language may be asked to leave the class, with no refund or make up session.


I hereby consent to my child’s participation in the program on the terms and conditions set out above by checking the agree box and signing below.


Agree

Digital Waiver Signature*







Step 2. Click the below button to submit payment via Sea Smart's online store. Note this will take you to a secure site hosted by Square.