STUDENT ATHLETE INFORMATION

Please choose all that apply. ​​​​​​
Do you believe that you qualify for financial aid or currently receive financial aid from a parochial or independent school?​​
Please note whether you will need morning or after care. ​
A deposit of $50 (full day) or $30 (half day) is due upon registration. Following a review of financial assistance documentation, we will provide the final amount due, if any.​​​​​​​​

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT INFORMATION

Please note: we will only contact this person should we be unable to reach Parent/Guardian 1 or 2 first.


HEALTH INFORMATION

CONSENT TO MEDICAL TREATMENT AND WAIVERS

In registering my child for this camp, I agree to the following:

Emergency Release

In the event that neither parent(s)/guardian(s) nor the emergency contact(s) can be reached, I authorize the release of my child into the custody of any person known to the Head of the School or his Agent whom the Head or his Agents believes is sufficiently responsible to care for my child. This could include releasing my child to a family of an Urban employee for temporary care.

Permission to Authorize Emergency Medical Treatment
In case of a medical emergency, I hereby authorize members of the Staff of the Urban School of San
Francisco to consent on my behalf to the administration of medical treatment including, but not limited to, emergency services, surgery, administration of medications prescribed by a physician, or other recommended treatment for my child.


Waivers

I hereby waive and release Urban School and the Urban School Sports Camp from any and all liability for injuries or illnesses incurred while at camp.

I also agree that Urban School is authorized to use any photographs, videos, artwork, written extractions and/or voice recordings of the student for publicity and/or advertising purposes.

For those selecting the financial assistance option, any further amount due will be billed upon completion of FA documentation.​​

Please provide an email address where we can send a link to your current form.

Email Address :