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Instructions
1.Print this form. (print 2 copies, so you can keep one.)
2.Read this form and sign all three policies.
3.Return this form with payment to FIRST by one(1) week from your registration date. Fax number: 603-647-5772. Mailing address:
 FIRST - Finance Department
 200 Bedford St.
 Manchester, NH 03101
4.Mail or deliver the following on or before the first day of the program:
 -Proof that participant has had a physical within the last 2 years. (In compliance with Safety Regulations of the State of NH.) A photocopy of a physical from school or another program or camp is acceptable.
 -Copy of the participant's immunization record (if not included on the physical form.)

Policy Information
Safety Policy:
 FIRST Place does not take responsibility for any injury sustained during this program. Basic safety precautions will be followed at all times. This health history is correct to the best of my knowledge, and my child has permission to engage in all scheduled activities as noted.
 
signature of parent/guardian:_____________________________________________________date:____________________
Acceptable Behavior Policy:
 FIRST Place has an acceptable behavior policy, which states that your child will behave in an acceptable manner, use acceptable language, and use the Internet in an acceptable manner. Behavior or language that disrupts the program for staff or other children is unacceptable. Unacceptable use of the Internet includes retrieval of explicit material or searching areas that are considered off-limits. Any child violating this policy will be given one verbal warning, the parent/guardian will be called, and then the child will be discharged from the program if a third violation occurs. No refunds will be given in this instance.
 
signature of parent/guardian:_____________________________________________________date:____________________
Media Policy:
 At FIRST, we have many exciting and ever-changing forms of providing information to the public about our programs. Since it is difficult to know who may or may not be videotaped or photographed by our staff, visiting media or news organizations, it is necessary to have a signed release from all participants on file. Please provide the information to complete this form. Thank you for your cooperation and for allowing your child to be part of FIRST Place. I understand my child may be photographed or interviewed during his/her participation in a program at FIRST Place, and that my child's image might subsequently appear in print promotional material or on the FIRST web site. I understand the release given herein, is made without compensation, and that no compensation is required or anticipated. The FIRST organization, its programs, partners, and their affiliates are released from any and all liability, claims, or causes of action. I give FIRST (For Inspiration and Recognition of Science and Technology) permission to use my child's likeness in materials promoting FIRST and FIRST Place programs.
 
signature of parent/guardian:_____________________________________________________date:____________________
External Camp Waivers:
 If your child participates in the Rock Climbing - A Sport of the Mind camp, you will also need to complete an additional waiver, which can be downloaded from: http://verticaldreams.com/waiver.php
With Questions contact firstplace@usfirst.org or call 1.800.871.8326 ext.#427
Once you have printed this page, you have completed the web registration and may close this window.
Camps begin each day at 9:00 AM and end at 3:00 PM, Monday through Friday (Registration on the first day of camp starts at 8:30 AM). Drop off is at the glass tower in front of the FIRST Building at 200 Bedford St., in Manchester, NH. You must come inside FIRST Place to pickup your child each day. FIRST will provide snacks and juice, however, the campers need to bring a lunch each day. The week will culminate on Friday with Parent Participation Day when parents and friends are invited to join in the grand finale with the campers.