AKM SUMMER CAMP
REGISTRATION FORM 2021

VIRTUAL FORM

SUMMER CAMP 2021

Packed with activities and adventure for ages 6–8 and 9–12, our Virtual Summer Camps 2021 are offered in six sessions! This year’s Camp theme is “State of Play.” What goes into making a game? How many games do you know that use a ball? A stick? A rope? A hoop? Find out during a week of fun-filled activities for children ages 6-8 and 9-12. Let’s explore the concept of PLAY!

PROGRAM SELECTION:

Please mark the program(s) you have registered for:

STATE OF PLAY: JULY 5-9
PLAY DECONSTRUCTED: JULY 12-16
GLOBAL GAMES: JULY 19-23
PERSPECTIVES OF PLAY: JULY 26-30
PLAY OF IMAGINATION: AUGUST 9-13
SOUNDS AND WORDS: AUGUST 16-20
DISCOUNT

Friend: $270 (10% off Regular)
Sibling: $270 (10% off Regular)
Sibling Friend: $243 (10% off Friend)




TOTAL: $0.00



REGISTRATION FORM:
PERSONAL INFORMATION

Information collected on this application form, including personal information, will be used by the Aga Khan Museum to register the herein named child in the Virtual Summer Camp and to communicate with you and the child in connection with such program and for such other purposes as described in these forms. For more information on the Museum’s privacy policy, please visit https://www.agakhanmuseum.org/privacy-policy. If you have any questions about the Museum’s privacy policy, please contact: privacyofficer@agakhanmuseum.org.

VIRTUAL CAMP INFORMATION
What device will your child be using for the virtual camp sessions?


Have you used the Zoom video platform before?

PARENTAL CONSENT (REQUIRED FOR EACH CHILD): [Please read carefully and indicate your acceptance by confirming acceptance by acknowledging below]:

I hereby apply for registration for the herein named child for the Virtual Summer Camp(s) indicated in this application. In consideration of acceptance of this application by the Aga Khan Museum (the “Museum”), participation in the Virtual Summer Camp(s) and other good and valuable consideration, I hereby acknowledge and agree as follows on behalf of myself (where applicable) and my child:


a. To allow my child to participate in all Virtual Summer Camp activities;


b. That the Museum has enhanced procedures and requirements in place as a result of the COVID-19 pandemic, which are described on the Museum’s website and which may also be communicated to me from time to time by the Museum, and I agree and accept that all such procedures and requirements are reasonable, and I further agree that I will comply and cause my child to comply with all such procedures and requirements as same may be amended from time to time by the Museum. I also agree that I will comply and will cause my child to comply with all Public Health requirements and guidelines relating to COVID-19 (including, without limitation, personal hygiene protocols, masks and physical distancing requirements) and I understand and acknowledge that it is my responsibility to stay up to date with all such requirements and guidelines and to strictly adhere to same and to cause my child to be aware of and adhere to same;


c. That notwithstanding any of the Museum’s enhanced procedures and requirements that have been put in place to help stop the spread of COVID-19 and other contagious diseases, I understand and agree that the Museum cannot guarantee that my child will not transmit, contract or become infected with COVID-19 or another contagious disease while participating in the Virtual Summer Camp(s) or while otherwise at the Museum;


d. That neither I, my child nor anyone in our household has tested positive for COVID-19 or other contagious diseases or has exhibited symptoms of COVID-19 or other contagious diseases and I will promptly notify the Museum of any changes to this representation should such a change occur prior to the commencement of the Summer Camp(s), during the period of the Summer Camp(s), or within 30 days of its conclusion and I shall fully cooperate with the Museum and public health authorities, as necessary to help to stop the spread of the viruses and to protect the health and safety of other Summer Camp participants, administrators and others.


e. I understand and agree that the Museum shall not be responsible for, and the Museum hereby expressly disclaims, to the fullest extent permitted by law, any and all losses, injuries, damages, claims, expenses, interferences or inconveniences (together, “Losses”) that I or my child may suffer which is or may be caused by COVID-19 or other contagious diseases including with respect to exposure to or the transmission or contraction of COVID-19 or other contagious diseases or which I or they may suffer as a result of any technology delays, interruptions, issues or other causes beyond the control of the Museum.


f. That the Museum will be collecting, using, disclosing, sharing and storing personal information about me and my child in connection with the Museum’s implementation and administration of the Virtual Summer Camp(s) and for other services I have (explicitly or impliedly) requested, and I hereby agree and consent to such collection, use, disclosure and storage of such personal information for such purposes. I also understand and agree that such personal information may be shared with certain third parties including Virtual Summer Camp Supervisors and educators, medical personnel as required, and various third-party service providers and as further described in the Museum’s privacy policy: https://www.agakhanmuseum.org/privacy-policy.html. I understand that if I have any questions or concerns about the Museum’s privacy practices, I can contact privacyofficer@agakhanmuseum.org.


g. That the Museum may use my personal information to contact me in the future to inform me about upcoming camps and programs of the Museum. I understand that such implied consent is provided by virtue of registering my child in the present Summer Camp(s) and that the Museum may rely on such consent. I understand that I may be requested to provide a separate explicit consent to opt-in to receive other types of communications from the Museum.


h. To give the Museum officials authority to act on my behalf in case of emergency and in the best interests of my child if I am not present at the time of the emergency but I understand and agree that such authority shall not be construed as requiring the Museum to act unless required to do so by law;


i. That, in the event of an illness, injury or other emergency suffered by my child during the Virtual Summer Camps, I understand and agree that the Museum will contact the camper’s emergency contact as soon as possible following the notification of any necessary emergency personnel. I understand that my child must always have their medication with them and must be able to administer their own medication without assistance. I further agree that no employee, agent, representative or volunteer of the Museum or of any of its partners will be held responsible for injuries or damages arising from or otherwise in connection with the provision (or lack thereof) of any such emergency medical attention or treatment;


j. That my child will comply with the rules and policies, including without limitation the Behavior and Discipline Policy (available online) of the Museum and the Virtual Summer Camps’ instructors and educators and failure to do so may result in termination of participation in the Virtual Summer Camps without penalty to the Museum;


k. That the Museum reserves the right to terminate, without penalty, the registration of my child in the Virtual Summer Camp(s) when it is deemed in the best interests of the child or the Museum, as determined by the Museum in its sole discretion;


l. That my child is solely responsible for their personal effects and belongings, including but not limited to electronic devices and electronic accessories used during to the Virtual Summer Camp(s); and


m. That I am solely responsible for my child’s welfare and wellbeing while they are participating in the Museum’s Virtual Summer Camp(s) and the activities thereof.


IMPORTANT WAIVERS, RELEASES AND INDEMNITIES BELOW. PLEASE READ CAREFULLY.

n. To release, hold harmless and forever discharge the Museum and its directors, officers, trustees, members, employees, volunteers, representatives, agents and those for whom it is responsible in law (collectively the “Releasees”) from any and all liability, actions, causes of action, claims and demands resulting from any loss, injury or damage to person or property that I or my child may suffer in connection with my child’s participation or involvement in the Virtual Summer Camps due to any cause whatsoever, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE RELEVANT OCCUPIERS LIABILITY ACT OR ANY OTHER RELEVANT STATUTES, on the part of the Releasees;


o. TO NOT SUE THE RELEASEES or any of them for any loss, injury (including exposure to, transmission or contraction of COVID-19 or other contagious diseases), costs or damages of any form or type, howsoever caused or arising, and whether directly or indirectly from the participation or other involvement of my child in the Virtual Summer Camps;


p. TO INDEMNIFY, and to SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them whether the claim is based on the negligence or the gross negligence of the Releasees or otherwise; and


q. That I have read this document and all the forms attached hereto and sent to me in connection with my child’s enrolment and participation in the Virtual Summer Camps and understand their content, terms and implications;

I HAVE READ AND UNDERSTAND THIS AGREEMENT AND ALL ASSOCIATED PERMISSION FORMS I AM AWARE THAT BY SIGNING THIS AGREEMENT AND ASSOCIATED PERMISSION FORMS I AM WAIVING CERTAIN SUBSTANTIAL LEGAL RIGHTS WHICH MY CHILD, THEIR HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS AND I MAY HAVE AGAINST THE RELEASEES OR ANY OF THEM.
I SIGN THIS DOCUMENT AND ALL PERMISSION FORMS VOLUNTARILY AND WITHOUT INDUCEMENT.
CAMPER AND PARENT/GUARDIAN GUIDELINES FOR VIRTUAL SUMMER CAMP(S) [Please read carefully and indicate your acceptance by signing below]:

Certain responsibilities and obligations must be followed by campers and their parents/guardians in order to participate in the Aga Khan Museum Virtual Summer Camp. Those guidelines relating to the Virtual Summer Camp(s) are as follows and may be amended from time to time:


Use of Third-Party Applications

As part of the Virtual Summer Camp, the Camp will require the use of third-party applications (Zoom). Please acknowledge and agree as follows:


a. Parents/Guardians and campers will comply with the terms and conditions of the third-party application including following any account opening procedures, only using the application for the purposes permitted in its terms and conditions;


b. The Aga Khan Museum has no liability to campers or their parents/ guardians in respect of any third-party applications or platforms. The Aga Khan Museum does not endorse and is not responsible for any Losses relating to the third-party applications or platforms.


Camper will:

a. Arrive on time and be prepared for their virtual camp.


  • Jr. Campers arriving between 10:50 – 11 am EDT
  • Sr. Campers arriving between 1:50 – 2 pm EDT

b. Sign into the third-party application (ex. Zoom) using registration link.


c. Sign into the third-party application (ex. Zoom) using their first name only and not nicknames.


  • This is done to allow the instructor to review any behavior issues as they are brought up and to ensure personal details are not shared or visible;

d. Wait patiently in the waiting room for the Virtual Summer Camp instructor or host to allow them in. Only registered participants will be allowed into the room;


e. Dress appropriately and ensure camper backgrounds are appropriate to a positive camp environment.


  • Find a place at home where the camper will not be distracted so they can be a part of the Virtual Summer Camp.
  • Ensure the space is free of any personal items or pictures.
  • Be sure the space is free of breakable items and there is some room to move;

f. Follow the instructors’ guidelines for the use of third-party video conferencing platforms (Zoom);


g. Keep their video on for the duration of the live portions to ensure they stay focused and to ease communication with our staff.


h. Be engaged during the course of the Virtual Summer Camp and communicate with instructor and other campers with respect to all interactions, including video conferences and break out rooms. Do not type something in a chat that they would not say in person;


i. Never post, publish or display any obscene, defamatory, threatening or otherwise discriminatory material;


j. Tell their camp instructor if they see other campers being threatened, intimidated or bullied online.

  • Report activities motivated by bias, prejudice or hate to the Virtual Summer Camp Instructor.

k. Use resources provided for the Camp for authorized purposes only, including copyrighted software, videos or activity sheets;


l. Never record, screenshot or take pictures of the instructor, guest speakers or campers on the video conference without written consent of that person or persons, and without written consent of that person or persons parents/guardians;


m. Never share images/videos from a virtual classroom with family and friends or on social media or otherwise without permission.


n. Never share third-party platform link with friends or family.


Parents/Guardians will:

a. Ensure that emergency contacts are up to date. We may need to contact you and/or other emergency contacts for the following reasons:

  • There is a medical emergency relating to your child. A medical emergency is defined as an injury which is life threatening or could cause further damage if qualified medical treatment is not given immediately.
  • There is a behavioral issue that we feel you need to be aware of.
  • If your child is about to do something that we deem is unsafe or in violation of our policies and guidelines.
  • If your child leaves the screen for more than 5 minutes without us knowing where they are going.
  • If there is an incident during camp that we feel that you should be aware of
  • If your child is having technical issues - i.e. was removed from the meeting for some reason and cannot get access back in.

b. Ensure adequate supervision is provided, including, but not limited to:

  • Ensuring physical supervision of the camper(s) for the duration of the camp;
  • Ensuring internet safety for the camper(s);
  • Finding an appropriate learning space (e.g. quiet, free from distractions as much as possible, does not compromise family or household privacy, etc.);
  • Ensuring that physical activities are done in a safe and appropriate environment;
  • Ensure no other non-registered household members walk in and/or participate in camp activities.

c. Contact the Virtual Summer Camp Instructor directly by email or phone to discuss concerns or ask questions about any aspect of the virtual classroom.


  • This should be done outside the instructional time.
  • Under no circumstances should a parent/guardian interrupt during synchronous learning except in the case of a medical or life-threatening emergency.

d. Provide any equipment needed for the Virtual Summer Camp, such as a computer, tablet, internet access, webcam, microphone, etc.


e. Never share third-party platform link with friends or family.


f. Use resources provided for the Camp for authorized purposes only, including copyrighted software, videos or activity sheets;


g. Understand that any damage to provided equipment is the sole responsibility of the owner of said equipment and will not hold the Aga Khan Museum responsible for any damage that may happen to the provided equipment during Virtual Summer Camp;


h. Ensure that camper(s) have all of the supplies required for successful participation in the Virtual Summer Camp and ensure that resources provided for the Camp are used for authorized purposes by the intended user only;


i. Never record or take pictures of the instructor, guest speakers or campers on the video conference without written consent of that person or persons, and without written consent of that person or persons parents/guardians;


j. Never share images/videos from a virtual classroom with family and friends or on social media or otherwise without permission;


k. Review, understand and accept the terms and conditions, including privacy policies, of any video conferencing and third-party platforms used in the course of the Virtual Summer Camp; and contact the Camp if they have any concerns. Not all concerns will be capable of being resolved and failure to accept the terms and conditions could lead to ineligibility or removal from the Camp.

ACCEPTANCE AND AGREEMENT
I have the capacity and legal authority to sign this CAMPER AND PARENT/GUARDIAN GUIDELINES FOR VIRTUAL SUMMER CAMP(S) agreement and I have read and understood the terms above and am signing this consent voluntarily and without inducement.
I SIGN THIS DOCUMENT AND ALL PERMISSION FORMS VOLUNTARILY AND WITHOUT INDUCEMENT.



PHOTOGRAPHY AND VIDEO PERMISSION

During the course of the Aga Khan Museum (“Museum”) Virtual Summer Camp and related activities, images may be taken of your child(ren) as well as your child(ren)’s works of art for use in the marketing, advertising, promotion of Museum programs, fundraising campaigns, and exhibitions. No personal identifying information (i.e., full name/address) will be associated with the use of the image(s). To signify your consent please sign where indicated below.


I, the undersigned on behalf of my minor child(ren), give permission to the Museum to use, share, disclose, and publish photographs, videos, and other recordings (including audio) of my child(ren) and their likeness and their works of art, without restriction. I also give permission to the Museum to modify and edit (e.g., crop, adjust coloring, etc.) or create derivative works of same as needed or as may be desirable to promote the Museum, its programs, and offerings and for other non-commercial purposes to advance the Museum’s mandate and purpose. I hereby waive any right to inspect or approve the use of the images or recordings or of any written copy.


By giving this consent on behalf of my minor child(ren), I understand and acknowledge that:


I am hereby irrevocably granting permission to the Museum the right to use and incorporate (alone or together with other materials) to perpetually, exclusively use photographs, video, and/or other recordings taken of my minor child(ren) and their works of art (in whole or in part) as a result of their participation in activities/events of the Museum or otherwise for all media throughout the world whether presently in existence or invented in the future.


I understand that neither I nor my child(ren) will be paid any compensation of any kind and I, on behalf of myself and my child(ren), waive any right to royalties or other compensation arising from or related to the use of the images, recordings, or materials. I acknowledge that the Museum owns all rights to the use of the images and recordings.


I, on behalf of my minor child(ren), forever release and discharge the Museum and all of its directors, officers, employees, members, agents, volunteers, and representatives (collectively, the “Releasees”) from any and all liability for any claim, action, demand, or controversy, including claims of invasion of privacy or violation of publicity rights, that I or my minor child(ren) might otherwise have in connection with the use of my minor child(ren)’s photos, videos, recordings, likeness, and artwork. This consent, waiver and release is binding on me, my child(ren) and our respective heirs, executors, administrators, and assigns and shall survive termination of the Virtual Summer Camps. The terms of this consent, waiver and release are in addition to any other consents, waivers, releases and indemnities I have given in connection with my child(ren)’s enrollment, participation and/or involvement in the Virtual Summer Camps. If there is a conflict on inconsistency between the terms contained in this document and the term(s) contained in any other document, I understand and agree that the terms that provide the Museum with the greatest set of rights and protections shall prevail.




HEALTH INFORMATION (REQUIRED)

The personal information contained on this form and the registration form will be used to support, wherever possible in a virtual environment, medical and emergency situations*, to understand your child’s unique needs which may impact their participation or those of others in the Virtual Summer Camps, to help safeguard the wellbeing of all campers, and to help administer the Virtual Summer Camps as effectively as possible. You understand and acknowledge that the Museum will not be able to respond to medical or other emergencies that your child may experience during their virtual participation in the Virtual Summer Camp and that your child should be appropriately supervised in their household during the time of their attendance.


The form will be kept on file together with the child’s Virtual Summer Camp registration form, and copies of same may be shared with the Camp Supervisor(s) and educators. The personal information collected in connection with your child’s registration in the Virtual Summer Camps is collected in accordance with the principles of applicable privacy laws Such personal information will only be retained for as long as is necessary for the purpose for which it was collected, after which it will be destroyed, erased, or de-identified (unless retention is needed for legal or compliance purposes).

HEALTH DETAILS

Please provide detailed information about any medical and/or behavioural conditions and describe the necessary action required in the event of a medical emergency. Should there be an emergency involving your child which Camp personnel respond to based on their judgment, you will be contacted as soon as possible following the notification of any necessary emergency personnel. While your child must always be appropriately supervised in their household while participating in the Virtual Summer Camp, please provide any steps that you would like our virtual summer camp staff to administer in case of emergencies involving your child. This will be the Emergency Response Plan.









EMERGENCY CONTACTS (REQUIRED)

Below, please provide the details of three emergency contacts that our Virtual Summer Camp Staff can contact.


1
2
3

HEALTH PERMISSIONS AND CONSENTS (REQUIRED)

I, the undersigned, agree as follows on behalf of myself (where applicable) and my child whom I am registering for the Virtual Summer Camp(s):


a. I have read and understood the Health Form and agree to the terms therein contained.


b. I have read and understood the Museum’s Emergency Response Plan in the event of a person having a medical emergency and it meets the standard of care required for my child.


c. I give permission to the Aga Khan Museum to share this completed Health Form to attending Aga Khan Museum staff, agents and volunteers who have a need to know such information in connection with the implementation of the Virtual Summer Camp(s) in which my child is participating.




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