Kids Camp Enrollment Form 2024

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Summer Camp Programs

Is parent / grandparent a member of Chequessett Club?
Is parent / grandparent a full time resident of Cape Cod?
Price: $1.00

Skillset evaluation

Parent Informaton


Authorized Pickup

Most Recent Physical Form

Click or drag a file to this area to upload.

Reservation Policy

I understand and agree to the following: Unless prior arrangements have been made with Chequessett Club Management, a child will not be reserved a spot in Kids Camp until ALL the following items have been received: Completed 2024 Enrollment Form, Copy of most recent physical exam or comparable health certificate, Chequessett Club Child/Parent Agreement, Payment


I understand and agree to the following: Must be signed by parents and understood by the child. A signed copy of this agreement must be returned to CYCC along with the Enrollment Form. It is important that all campers and parents have a full understanding of, and be in agreement with the overall CYCC philosophy, ideals, and goals related to group activities and community involvement. I understand that there are numerous risks associated with participation in the CYCC Kids Camp, including but not limited to activities such as sailing, swimming, tennis, golf, and hiking. A complete listing of inherent and other risks is not possible and there may be some risks that cannot be anticipated. Risks that contribute to the unique character and desirability of the activities involved pose the possibility of severe injury, illness, or death. I further understand that the activities involved will take place in an outdoor environment and upon open water where unalterable weather conditions may pose risks beyond the control of CYCC. If a threat of dangerous weather or conditions not suitable for scheduled activities should arise, under the discretion of the Camp Director, the camp may be postponed or canceled. I understand CYCC reserves the right to determine whether or not a child is able to meet the physical and emotional rigors of the program. The parent or guardian signing below understands that CYCC relies upon the information contained in the application, medical form, and other forms provided on behalf of the child. The parent or guardian below assumes all risk of loss arising from information that may not be accurate or complete and agrees to indemnify CYCC, its officers, directors, successors, and assigns all claims for loss, damage or injuries sustained to the child and relating to such incomplete or inaccurate information. I further understand that CYCC is not a therapeutic program or treatment center. Furthermore, it is understood by parents and children and is agreed that: • Cell phone use will not be allowed during the day’s activities. If the child brings a cell phone, the phone will remain secured in the CYCC Camp Supervisor’s office until the day’s activities are over. • There shall be no smoking or use of smokeless tobacco products by participants at any time. • There shall be no drinking of alcoholic beverages by children on CYCC property, use of or involvement in marijuana, narcotics, or controlled substances or accompanying drug equipment • Weapons and firearms are not permitted. • In the event of misconduct or other circumstances, CYCC reserves the right, in its sole discretion, to expel a child before the completion of the session in which the child is enrolled. No refunds will be given if expelled. • If a child misses a day of camp due to illness or injury, make-up will be offered only if space is available and with authorization from the Camp Director. Please note make-ups are not offered under normal circumstances other than the above stated. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by CYCC to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for my child named above. My child may use, under the supervision of CYCC staff, hazardous equipment involved in but not limited to activities such as sailing, tennis, and golf. I give permission for my child to participate in all camp activities. I acknowledge and assume the risks involved in these activities, and for any damage, illness, injury, or death resulting from such risks for myself and my child. There are no physical, emotional, or mental problems or limitations associated with my child’s participation in camp activities, except as disclosed by me in writing to CYCC. I have also read, and discussed with my child, and understand and agree to the terms on all pages of this application, including the Child/Parent Agreement. If my child chooses not to participate, I understand there will be no refund or make-up days. I understand that CYCC takes photos of the camp and its campers, which may be used on the CYCC website and in CYCC advertising, without revealing any personal information. I permit CYCC to use photos for such purposes. I have read, and discussed with my child and understand and agree to the terms of this application, including the Child/Parent Agreement. Participants and their parents/guardians will read all materials sent and complete all forms in a timely manner required for participation.


Electronic Signature
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