Enroll Today!Program activities on-demand, to fit the needs of your youth and your schedule. SIGN UP Enroll Now Name * Parent/Guardian First Name Last Name Email * Parent/Guardian Phone * Parent/Guardian (###) ### #### Address * Parent/Guardian Address 1 Address 2 City State/Province Zip/Postal Code Country Name * Student/Camper First Name Last Name Youth's Date of Birth * MM DD YYYY Name * Emergency Contact #1 First Name Last Name Phone * Emergency Contact #1 (###) ### #### Name * Emergency Contact #2 First Name Last Name Phone * Emergency Contact #2 (###) ### #### Code of Conduct Agreement * Code of Conduct All members are to respect other member’s space, privacy, possessions, freedom of opinion and expression. If all students and parent(s)/guardians agree to this code of conduct, please sign the designated spaces below. Any students that do not follow this code of conduct despite having constructive conversation to correct his/her behavior with staff members, parent(s)guardian will be contacted to pick up their child. In regards to safety, bullying, harassment and or aggressive behavior towards other members, we reserve the right to terminate student’s enrollment and the tuition will not be refunded. We Absolutely Do Not Accept Bullying and/or Harassment. To provide a safe and comfortable educational experience, our staff will see to it that if any person is found to be bullying or harassing another individual in any manner (physically, verbally, or in any other form), the offending member will be immediately removed from the group and their parent(s)/guardian will be contacted. Physical or verbal obscenities, any form of discrimination, and any general form of disrespect to other students and campers, staff, volunteers, or facility property will not tolerated. All students are expected to stay with their assigned groups for the entirety of the classes/camps, participate in daily activities, and comply with all rules and safety regulations. Possession of alcohol, unauthorized medications, firearms, or weapons is not permitted. I understand that my child will not be released to any person(s) not listed on the enrollment form. Authorization by telephone will not be accepted. I understand that I am not to leave my child at the program site unless a PVG staff member or volunteer is there to receive and supervise my child. I understand that it is my responsibility to sign my child in the morning and sign my child out before leaving in the afternoon. Sign-in / Sign-out sheets are available as you arrive at the program area. I understand that the PVG staff is mandated to report any suspected cases of child abuse or neglect to the appropriate authorities for investigation. I understand that PVG and volunteers are not allowed to babysit or transport children at any time outside of the PVG facility and program unless permitted by the parent(s)/guardian's through written and signed consent.. PVG management will take immediate disciplinary action against any staff and volunteer that violates this policy. All applicable guidelines stated in our code of conduct also applies to our online classes/camps. I Agree I Disagree Participant Waiver Agreement * Phoenix Vusion Group Participant Waiver Form Camp & Class Hours: As a courtesy to PVG members, please observe the schedule. Staff will remain with your child until they are picked up after each session; likewise, students should be dropped off no earlier than 15 minutes prior to day camp start time. If you absolutely need to drop off your child earlier, please call us at 1(408)-775-8899 (5) business days prior, to arrange extended day options. If we are unable to answer your call, please leave us a brief message and we will get back to you as soon as we can. Lunch, Snacks, Food Preferences, Allergies: Microwaves are available on-site. If your child has a food allergy, food restriction, or food aversion, please be sure to disclose it on page 2 of this registration form. You are welcome to send snacks for your child(ren), in addition to the snacks that we offer to our students and campers. If your child(ren) has any server allergy, or travels with an EpiPen, you must alert staff at drop-off and provide explicit written instruction on your child(ren)’s waiver. We do not guarantee an allergy-free environment but will do our best to accommodate your child(ren). Healthy Camper Policy: For the health of all PVG members, please keep your child(ren) at home if they are showing signs of sickness. If your child(ren) becomes ill during the program, you will be contacted immediately. If a parent or legal guardian is unable to be reached, the child(ren)’s emergency contact will be notified. It is the responsibility of the parents or guardians to arrange for their child(ren)’s transport from the program as soon as possible. If your child(ren) or anyone in your immediate household develops a reportable communicable disease as defined by the California Department of Public Health (www.cdph.ca.gov), it is the responsibility of the parent or legal guardian to notify PVG within 24 hours or the next business day in order for PVG to take proper action, including restricting your child from attending the day camp for the safety of other children and staff. Medical Emergency / First-Aid Policy: Your signature authorizes the management and staff of PVG to provide routine health care, administer and/or dispense prescribed medications, and seek emergency medical treatment. You agree to the release of any records necessary for insurance purposes. You also give permission to PVG to arrange for necessary related transportation for your child. If we are unable to reach you in an emergency, you hereby give permission to a physician selected by PVG to secure and administer treatment, including hospitalization, for your child. In consideration of your acceptance of this medical authorization, and you intending to be legally bound for yourselves, your heirs, executors and administrators, you hereby release all rights and claims that may arise against PVG and persons affiliated with this day camp. In addition, you agree to assume all financial responsibility for any medical or ambulatory expenses incurred in connection with your child(ren), Payment Policy: In order to reserve a space prior to the start of the day camp/class, all pages of this application must be completed in full and signed by the announced due date, this includes providing all medical information requested. Absences/Cancellation/Credit/Refund/Rescheduling Policy: We know that schedules change, and we are willing to consider making changes with seven days prior notice, if availability allows. If you need to change the week that you are registered for, we will consider a schedule change, space permitting, with seven days prior notice. Any other credits are issued at management’s discretion. Any credits expire within the same semester or camp it was issued. Cancellation with refunds are permitted with five business days prior notice. To submit cancellations or schedule changes, please email info@pvgglobal.org. Upon obtaining a doctor’s note, we will accommodate missed-days without prior notice due to sudden unwellness and will issue credit for use another time within the semester or camp only able to be used in our personal locations since schools do not have means of a crediting system. Dress Code: Students should be dressed for comfort and safety. No open-toe shoes (i.e. no sandals or flip-flops) are allowed. Any day camper wearing open-toed shoes WILL NOT be permitted to participate in the day’s activities and the parent (or guardian) will be asked to take their child(ren) home to change shoes. Photographs or Video Recording: We will occasionally take photos and videos of a class activity that may be shared with other parents on our website or social media accounts, or for purposes of presenting our programs and organisation as a whole. By signing below, you hereby consent to our foregoing use of your child(ren)’s image in such photos and videos. Furthermore, you hereby waive any and all rights to inspect or approve the photograph, video, or other use of your child(ren)’s name, likeness, or image, including any written article, caption or other writing that may accompany such use of your child(ren)’s name, likeness, or image. You agree that neither you nor your child(ren) will receive any compensation for our use of such images. Release of Liability and Assumption of Risk: You acknowledge that there are certain risks of personal injury inherent in participating in our programs, events, classes, and/or other activities, which may result from unavoidable accidents or injuries. Participation in PVG’s camps or classes involves the use of scissors, cutting equipment, adhesives, and other art supplies and equipment with other people, which involves some risk of injury, particularly when used incorrectly or unsafely by your child or other students. With full understanding of the risks involved and despite this Release, you hereby consent to your child participating in our programs, events, classes, and/or other activities. The undersigned, individually and on behalf of the registered minor child, hereby waives, releases and discharges any and all claims for damage for death, personal injury or property damage, which you or your child may have in connection with your participation in this day camp. You hereby release PVG, its agents, its instructors, and its other students from any and all liability, claims and actions that may arise from injury or harm to your child, or from damage to your property in connection with your child(ren)’s participation in this day camp. You acknowledge this Release covers liability, claims and actions caused entirely or in part by any acts or failures to act by PVG, its agents, the instructors and other day campers, including but not limited to negligence, mistake, or failure to supervise. You also agree to defend and indemnify PVG and hold us harmless from all third party claims for any personal injury, death, or property damage arising from your child’s conduct. You further understand that this Release means that you are giving up, among other things, rights to sue PVG, its agents, its instructors and its students for injuries, damages, or losses that you may incur while participating in class/camp. You also understand this Release binds your heirs, executors, administrators, and assigns, as well as yourself. You have read the entire Release, and fully understand it and agree to be legally bound by it. Indemnification: The undersigned parent/guardian hereby represents and warrants to PVG, that he/she has the authority to execute this Participant Waiver Form on behalf of the minor child as his/her parent or guardian. The undersigned agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian. I Agree I Disagree Thank you!