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STEM Remix

Please feel free to email us at discover@igeneduacademy.com or text us at (202)257-8410 if you have any questions or difficulties registering.

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Participant Information

Name
Gender
MM slash DD slash YYYY

Contact Information

Contact Information

Parent/Guardian Information

Name*

Parent/Guardian Information

Name

Emergency Contact Information

Name*

Medical/Allergy Information

Do you have medical conditions and special needs?*
Do you have allergies and dietary restrictions?*
Self-administered medication*
*Nut allergy

Photography/Video Release Permission

I give permission for my child to be photographed and videotaped during program activities*
How did you hear about us?

Registration and Refunds:

iGen Educational Academy’s Participant Registration and

Registration and Refunds:

Registration and payment for iGen Educational Academy Summer Camp must be completed and submitted via website (https://www.igeneduacademy.com). Full payment is required at the time of registration to reserve the child’s space. Due to limited space, refunds will not be given. Participants may sign up for any or all of the weekly camps. There will be no proration of fees for any days or times a child participant cannot attend.

Age Guidelines:

iGen Educational Academy Summer Camp is for children ages 5 to 14 years old by December 2021 and no exceptions will be made. The participants will be divided into separate groups dependent on age.

Hours of Operation:

iGen Educational Academy Summer Camp hours are Monday-Friday 7 am- 6:30 pm. Please do not drop off your child prior to 7:00 am. If you are in need of before care (7am-8:00am) and/or after care (4pm-6:30pm), please register online. If an emergency arises, please email us at discover@igeneduacademy.com and bring payment upon pickup. Dates for the camp are June 28- August 27, 2021.

COVID-19 Guidelines

Students who are sick or who have recently had close contact (less than 6 feet for a cumulative total of 15 minutes or more over a period of 24 hours or direct physical contact) with a person with COVID-19 to stay home and get tested for COVID-19. Students should stay home and follow CDC recommendations if they have tested positive for or are showing symptoms of COVID-19. Masks must be worn indoors.

Pick-up and Drop-Off Procedures:

Children need to arrive between 7:50-8:00 am and must be picked between 3:45-4:00 pm. Parents/guardians can pull up in front of our building on 4th. and a staff member will meet your student. If you would like notification of your child’s arrival, please let us know.

Late Pick-Up Policy:

There will be a late-fee assessed for children who are picked up after 6:30 pm. The late fee is $1 per minute after 6:30 pm. Repeated late pick-ups may result in the removal of the participant from the program, with no refund for prepaid programs.

Expectations/Dismissal: Be sure to inform the Chief Innovation Officer and iGen Educational Academy staff of any limitations to your child’s participation and agree to abide by iGen Educational Academy sole judgment as to whether your child can be accommodated in the camp program. Failing to disclose any physical, emotional, or behavioral needs or conditions may result in the child’s dismissal from the program without refund. Children must follow the stated behavior expectations and safety rules and that iGen Educational Academy reserves the right in its sole judgment to dismiss without refund any child whose behavior interferes with the rights and safety of others or consistently disrupts group dynamics or activities. Medical Needs/Release: The health history you provide must be correct and accurately reflects the known health status of the named camper. The camper described has permission to participate in all camp activities except as noted by parent or guardian and/or an examining physician. As the parent or guardian, you give permission to camp staff to provide routine health care; to administer prescribed or over-the-counter medications as described; and to provide or obtain emergency care and transportation for the camper if needed. I give permission to the physician selected by the camp to order x-rays, tests, and treatment related to the health of my child both for routine health care and in emergency situations. If a parent or guardian cannot be reached in an emergency, you give iGen Educational Academy permission to the physician to hospitalize, secure proper treatment for, and order and administer medication, injection, anesthesia, X-rays, special procedures, or surgery for this child, if deemed medically necessary. You, parent or guardian, understand that you are responsible for the cost of any medical care or prescriptions your child requires. You agree to the release of any records necessary for treatment, referral, billing, or insurance purposes. I understand that information on this form will be shared on a "need to know" basis with camp staff. You understand that all medications must be in their original containers, unexpired, and labeled with specific instructions, including the child’s name and dosage, and that any prescription medications must include the full pharmacy label.

Immunizations and Physicals must meet the requirements of the District of Columbia Immunization Requirements. If your camper does not have health insurance or if you need an immunization/ physical exam waiver due to your family’s religious beliefs, please contact your camp’s Chief Innovation Officer. To ensure a successful camp experience please include any pertinent information regarding special needs (IEP’s, Behavior Plans, medical history) in the form below. We can accommodate on a case-by case basis in order to establish the best strategy for a great summer camp experience! Insurance: You, the parent or guardian, certify that the named camper is covered by health and accident insurance or Medicaid and that the policy information given is correct. Off-Site Trips: You, parent or guardian, give permission for your camper to participate in and be transported to any off-site trips as scheduled, including the park and swimming pool. Release/Pick-up: You, parent or guardian, understand the release policy as described and authorize iGen Educational Academy to release my child to the people/methods listed on this form. Dress Code: Children should dress appropriately for the activities scheduled. Clothing that displays drugs, alcohol, tobacco, offensive language, excessive bagginess, or is excessively revealing will not be permitted.

Special Circumstances:

Parents and guardians are required to inform the iGen Educational Academy LLC in writing of any special circumstances which may affect the child’s ability to participate fully and within the guidelines of acceptable behavior, including, but not limited to, any serious behavioral problems or special circumstances regarding psychological, medical, or physical conditions. Once the notice is submitted, a conference will be scheduled with the parent/guardian to discuss the special circumstances and whether iGen Educational Academy LLC can accommodate the circumstances.

Personal Belongings: Please put the child’s name on all articles of clothing, snack bags, bags, etc. Children should not bring toys, mobile phones, electronic devices, jewelry, money, or any possession of value with them to any of the programs. Children will be responsible for their belongings. Behavior Management/Discipline Policy: iGen Educational Academy staff will create a fun and safe environment for participants in the program. Praise and positive reinforcement are used as effective methods of behavior management. Children who do not respond to these methods or who are destructive to others or to property will be dealt with in a professional, positive, and timely manner to correct the behavior. The following procedures will be followed for behavior management. All incident reports will be discussed privately with parents/guardians and a copy of each report will be kept on file at iGen Educational Academy. 1. In the event a child’s behavior is a repeated behavior and cannot be corrected by the iGen Educational Academy’s staff with a verbal warning or other form of behavior modification, a first incident report will be written to document and correct behavior. A copy of the report will be given to the parent/guardian the same day as the incident. 2. A second incident report will be written if the behavior is repeated by or new behavior problems occur with the same child. This report will follow the same process as the first, but a one or two day suspension could accompany this report, and no refund will be provided for suspended days. A copy of the report will be given to the parent/guardian the same day as the second incident. 3. A third incident report will be completed using the same process as the first two. iGen Educational Academy’s staff will write this report. Staff will provide this report to the parent/guardian. Incident reports will be discussed privately with a parent/guardian by an iGen Educational Academy’s staff and Chief Innovation Officer. Dismissal from a program can occur at this time.

NOTE: Immediate dismissal from the program can occur at any time given severe circumstances. Refunds for missed days due to a discipline dismissal will not be granted.

Nutrition/Snacks: Children must bring lunch, a snack and a drink in a non-glass container each day. Snacks should be in a paper, plastic, or reusable bag clearly labeled with the child’s name. Snacks must be peanut-free. Please do not send gum or candy.

Summer Camp Agreement of Terms:

Program: I give permission for my child to participate in all camp program activities similar to those described in the newsletter, camp brochure, website or information packet. I understand that iGen Educational Academy reserves the right to change program activities or instructors and cancel programs, should iGen Educational Academy decide in its sole judgment that it is necessary and appropriate to do so. Payment, Cancellation, and Refund: I understand and agree to the payment, cancellation, refund, and late fee policies as described in the camp’s newsletter, brochure, confirmation letter, or information packet.

I have read and agree to abide by the terms and policies listed above and those found in the camp newsletter, brochure, confirmation letter, or information packet.

I, the parent/legal guardian of the named camper, have read, understood, and agree to the above.

Policies

By signing this form, I, as parent/guardian, permit iGen Educational Academy to use pictures of my child(ren) as a program participant in promotional literature, videos, social media posts and iGen Educational Academy website. I understand my child(ren)’s name(s) will not be published. I, as parent/guardian of ______________________ (“Child”), hereby assume all risks and hazards incidental to the conduct of the activities at iGen Educational Academy and transportation to and from the activities. My Child is fit for the program(s) in which I have enrolled him/her. I HERELY RELEASE AND SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS RELEASEES FROM EVERY CLAIM AND ANY LIABILITY THAT I OR MY CHILD MAY ALLEGE AGAINST RELEASEES (including reasonable legal fees and costs) AS A DIRECT OR INDIRECT RESULT OF INJURY OR DEATH TO ME OR MY CHILD BECAUSE OF MY CHILD’S PARTICIPATION IN ANY IGEN EDUCATIONAL ACADEMY LLC PROGRAMS , WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERS TO THE MAXIMUM EXTENT PERMITTED BY LAW. I PROMISE NOT TO SUE RELEASEES ON MY BEHALF OR ON BEHALF OF MY CHILD REGARDING ANY CLAIM ARISING FROM OR RELATED TO MY CHILD’S PARTICIPATION IN ANY IGEN EDUCATIONAL ACADEMY PROGRAM(S). I ACKNOWLEDGE THAT, BY SIGNING THIS DOCUMENT, I AM RELEASING IGEN EDUCATIONAL ACADEMY, CAPITOL HILL PRESBYTERIAN CHURCH, AND THEIR REPRESENTATIVES, AGENTS, EMPLOYEES, VOLUNTEERS, MEMBERS, SPONSORS, PROMOTERS, AND AFFILIATES (COLLECTIVELY “RELEASEES”) FROM LIABILITY, AND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS SIGN UP AND RELEASE FORM IS A CONTRACT WITH LEGAL AND BINDING CONSEQUENCES AND IT APPLIES TO ALL ACTIVITIES IN WHICH MY CHILD ENGAGES DURING THE SUMMER CAMP AT IGEN EDUCATIONAL ACADEMY, REGARDLESS OF WHETHER SUCH ACTIVITY IS A PART OF A FORMAL PROGRAM. I HAVE READ THIS RELEASE CAREFULLY BEFORE SIGNING. I UNDERSTAND WHAT THIS RELEASE MEANS AND WHAT I AM AGREEING TO BY SIGNING. I understand that no insurance coverage for participants in these activities is not provided by iGen Educational Academy. By registering for this program, I understand and agree that if a portion of the program is unable to be completed due to unforeseen circumstances under responsibility of the iGen Educational Academy, I will receive a prorated credit on my account for the uncompleted portion of the program. I also understand that no refunds or proration will be given for any other reason.

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