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Summer Camp Application

  1. Gender

  2. Session Length

  3. Does your child have permission to view G and PG movies *

  4. I wish to enroll my child in: Summer Fun (Ages 5-12)

  5. I wish to enroll my child in Sports Camp Ages 13 - 16 and must bring a bicycle)

  6. Activities

    Please choose 1 activity for your child to participate in from 2pm - 4pm

  7. Monday

  8. Tuesday

  9. Thursday

  10. I do hereby agree to allow my child(ren) to participate in The City of Cocoa Beach Parks and Recreation Summer Camp. 1.) I hereby agree to release, absolve, indemnify and hold harmless the City of Cocoa Beach, its officials, camp organizers, sponsors, transportation providers, employees, volunteers and their families, and agree to hold them all harmless from any loss, liability, damages or costs that may occur, whether caused by the actions or negligence, active or passive, or otherwise, while my child(ren), or any participating child is in, upon, or about the premises of any facilities or equipment therein or participating in any program affiliated with the City of Cocoa Beach, and/or its Summer Fun and Sports Camp.

  11. I acknowledge and accept the risk that my child(ren) and other members of my family or household, and I may be exposed to or be infected by Covid-19 by my child(ren) attending the Summer Camp program and that such exposure or infection may result in personal injury, illness, permanent disability, disfigurement and death. I acknowledge and accept the risk to have contact with individuals, who have been exposed to and/or have been diagnosed with one or more communicable diseases, including but not limited to COVID – 19 or other medical conditions, or diseases. I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and/or others, including, but not limited to, City employees, volunteers, and program participants and their families.

  12. 3.) I agree that my child(ren) will comply with the stated and customary terms and conditions for participation.

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