Student Information

as of June 1, 2017
(mm/dd/yyyy)​

Parent/Guardian 1

Father, mother, guardian​​

Parent/Guardian 2

Father, mother, guardian​​​

Emergency Contact

Choose Your Session Options

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Select "Yes" if you are WMA Faculty & Staff, a Beech Tree alum or have been authorized to receive a camp rate that differs from those listed above.​​​​​​​​
Select as many that apply​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​
as of June 1, 2017
(mm/dd/yyyy)
Select as many that apply​​​​​​​​​​​​​​​​​​​​​
Let us know any additional important information here:​​​​​​​​​​

Terms & Conditions

Student/Parent Agreement

It is important that all students and parents have full understanding of, and be in agreement with the overall Wilbraham & Monson Academy Summer Programs philosophy, ideals and goals related to group living and community involvement.

I understand Wilbraham & Monson Academy Summer Programs program is an active, outdoor, and in some cases group living experience, that is positive and constructive in nature. The program requires full and complete participation from all participants.

I understand that there are numerous risks associated with participation in any program activities, including but not limited to activities such as swimming, hiking, athletics, and transportation to and from program activities. 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 some activities involved will take place in an outdoor environment where unalterable weather conditions may pose risks beyond the control of Wilbraham & Monson Academy Summer Programs.

I understand Wilbraham & Monson Academy Summer Programs reserves the right to determine whether or not a child is able to meet the physical and emotional rigors of summer programs life. The parent or guardian signing below understands that Wilbraham & Monson Academy Summer Programs relies upon the information contained in this application form, medical information and other information 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 Wilbraham & Monson Academy Summer Programs, its officers, directors, successors and assigns against all claims for loss, damage or injuries sustained to the child and relating to such incomplete or inaccurate information.

Further, it is understood by parents and students and is agreed that:

1. There shall be no smoking or use of smokeless or other tobacco products by students at any time.

2. There shall be no drinking of alcoholic beverages by students on the camp property or during any summer program away from the property.

3. There shall be no use of or involvement in marijuana, narcotics, or controlled substances or accompanying drug equipment.

4. Weapons and firearms are not permitted, with the sole exception of the student’s supervised instructional programs, using equipment provided by WMA or its program coordinators.

5. Students and their parents will read all materials sent and complete all forms in a timely manner required for participation at the Wilbraham & Monson Academy Summer Programs.

6. Student enrollment is for the entire session term. Early departures are disruptive to the community and unit groups and not in keeping with our overall goals for the experience.

7. In the event of misconduct or other circumstances, Wilbraham & Monson Academy Summer Programs reserves the right, in it’s sole discretion, to expel a participant before the completion of the session in which the participant is enrolled.

Unless otherwise stated, my signature permits WMA to use photographs or video pictures of my child taken in the course of the program for publicity of the summer programs at Wilbraham & Monson Academy. I also allow WMA to share information via wma.us and social media for summer program purposes. In the event the local media covers a story for WMA's Summer Programs I allow my child to participate knowing this could result in on-air and online distribution.

My child may use, under the supervision of camp staff, hazardous equipment involved in regular activities. My child may participate in any trip or activity sponsored and supervised by Wilbraham & Monson Academy Summer Programs on or off the campus, and may travel when deemed necessary by the program via public carrier or vehicles operated by Wilbraham & Monson Academy Summer Programs. I give permission for my child to participate in all camp activities including those described on this form. 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, mental problems or limitations associated with my child’s participation in activities, except as disclosed by me in writing to Wilbraham & Monson Academy Summer Programs.

In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the Wilbraham & Monson Academy Summer Programs director to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for my child named above. I have read, discussed with my camper and understand and agree to the terms on both sides of the application including the above Student/Parent Agreement.

Fee Payment and Refund policy

  • Payment in full/partial due at registration
  • No student will be allowed to participate without payment and a completed health form
  • No refund will be given after June 1, 2019
  • No refund will be given for late arrival, absences, withdrawals or early departures
  • WMA does NOT charge a transaction or registration fee of any kind

Checklist

Payment & Signature

Amount is based on the program options chosen during registration.​​​​​​
If total is not accurate, go back and check your session options.
By typing your name below, you are agreeing to the terms above.​

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