Full STEAM Ahead: 
Summer Camps 2023

Youth Quarterback Academy
4th - 8th 
July 24th & 25th from 6:00pm - 8:00pm

July 24 - 25, 2023
July 21, 2023 12:00pm [Central Time]
INFO:   Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable. You may choose alternate options or join the waiting list.

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Registrant Fee: $0.00

Billing information

Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*EDGERTONEXPLORITCENT 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
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Registration inquiries:
Mary Molliconi
(402) 694-4032

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Camper Information
Camp Session Information
Scholarship criteria is determined by free and reduced lunch eligability.  For special circumstances please contact Mary at mary@edgerton.org or 402-694-4032
Adult Contact 
Our campers come from all over!  Some are from in town, some travel in, and some stay with local family and friends.  
We will need the contact information for the camper's legal guardian as well as the main contact during camp, should that information be different.

Edgerton Explorit Center Terms, Conditions, and Release of Liability Agreement

I, the undersigned, hereby acknowledge that I am over the age of 18, that I am the parent and/or legal guardian of the registered camper and that I have the authority to make agreements on behalf of my child, the registered minor.
I further acknowledge that I have voluntarily chosen to enroll my child in the Edgerton Explorit Center Summer Camp Program. I also give consent for my child's participation in all camp-related activities.

I understand that certain risks are inherent in any recreational activity. I agree that there may be risk of injury or harm to my child as a result of camp activities, and I knowingly and voluntarily assume all risks of such injury or harm. I also understand and agree that it is my and my child's responsibility to safeguard his or her personal belongings, and I knowingly and voluntarily assume all risk that personal belongings brought to camp may be lost, misplaced, damaged, or stolen. I hereby waive and release the Edgerton Explorit Center (and its board of directors, agents, partners, representatives, employees, contractors, and camp staff) from any liability, including but not limited to claims based on negligence or some other act or omission, for any injury, illness, or harm to my child or damage of any personal property incurred while at camp or during after-care.

I give permission for my child to be transported in a motor vehicle driven by an employee, board member, or volunteer of the Edgerton Explorit Center Summer Camp Program. I understand that my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or other adult volunteers. I have read, understand, and discussed with my child that: (1) They will be traveling in a motor vehicle driven by an adult and they are to wear their safety-belt while traveling; (2) They are expected to respect each other, the vehicles they ride in, and the people they travel with during the trip; (3) Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions or acts by riders, other drivers, or objects; and (4) They are to remain in their seats and not be disruptive to the driver of the vehicle. I understand that my child is not required to participate in this activity, but grant permission for him/her to do so, despite the possible risks. I recognize that by participating in this activity, as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses.

For everyone’s safety, children must follow all staff instructions. I understand that if my child's actions or attitude are deemed detrimental to other camp participants, camp staff, or the general camp atmosphere, he or she may be sent home without any reimbursement for any payment made to the Edgerton Explorit Center. I agree to accept full responsibility, financially or otherwise, for the conduct of my child — including paying restitution for damage to Edgerton equipment and property, camp facilities, and/or personal property of other participants. The Edgerton Explorit Center is not required or expected to protect camp participants from theft or damage to property.

MEDICAL AUTHORIZATION & SPECIAL NEEDS PERMISSION TO TREAT I understand and agree that I am responsible for determining my child's medical, physical or other qualifications and suitability for participating in the Edgerton Explorit Center’s camps and its activities. I agree to disclose to the Edgerton Explorit Center and camp staff any pertinent medical, physical, or other conditions and special needs that may affect my child's participation in these activities. I understand measures will be taken to safeguard the health and safety of all participants; however, in the event of medical attention becomes necessary I hereby grant permission of the Edgerton Explorit Center or its authorized representatives to arrange for such medical care that my child may require. This includes minor medical care by Edgerton staff members. In the event of serious injury or illness, the Edgerton staff will call 911. The Edgerton Explorit Center will also make all reasonable efforts to contact the parent, guardian and/or people listed as emergency contacts. I am aware that the Edgerton Explorit Center assumes no liability for the costs or provision of medical care in the event that care is needed during or after this program.

Some camp sessions may be videotaped or photographed. By registering for this camp, I grant permission for the use of my child’s image and voice; which may be captured through video, photo, digital camera or other media; in Edgerton Explorit Center training, promotional materials and publications, and other commercial purposes.

Cancellations made 30 days in advance of the first day of the camp session are eligible for a full refund. Cancellations made 10 days before the first day of the camp session are eligible for a 50% credit voucher. Cancellations made less than 10 days before the start of the camp session will not be refunded. The Edgerton Explorit Center reserves the right to vary its programs and to reschedule or cancel an event if it is under-subscribed or for any other reason. The Edgerton Explorit Center aims to give participants at least 1 weeks’ notice if an event is rescheduled or cancelled, and give a full refund for cancelled events.

By signing this Waiver and Liability Agreement, I acknowledge that I HAVE READ AND FULLY UNDERSTAND AND AGREE TO ALL OF ITS TERMS AND CONDITIONS INCLUDING PERMISSION TO TREAT AGREEMENT. I further state that I have executed this waiver and liability voluntarily and with full knowledge of its significance to be binding on me, my heirs, executors, and administrators.

Check this box to indicate that you have read and agree to all of the above terms & conditions