2018 MetroSquash Summer Camp Application

Submitting an application does not guarantee admission into our summer program. If selected, a MetroSquash staff member will call you to confirm your child’s spot and his/her dates of participation after submitting the application.

Guardian Information

Family Financial Statement
MetroSquash receives funding from Chicago’s Department of Family and Support Services which is dedicated to supporting services that enhance the lives of Chicago residents, particularly families in need. While we understand that financial information is sensitive, MetroSquash is asking each family to describe their financial situation so we can continue serving Chicago families in need. 

In the space below, please explain the status of your family’s finances. Information should include: yearly income and number of individuals in your household but can also include a description about parenting status, free/reduced lunch, financial government assistance, debt, or any other extenuating circumstances. Your response will be kept confidential and not shared with anyone outside of the MetroSquash staff.

MetroSquash Parental Consent
Liability Waiver
MetroSquash NFP, MetroSquash staff, and the participating squash facilities shall not be liable for any claims, demands, injuries, or damages to the student listed above (1) resulting from his/her participation in MetroSquash, including without limitation [practices, tournaments, tutoring, mentoring, field trips, traveling to/from MetroSquash activities, etc.] or (2) in connection with the student’s use of the MetroSquash Academic and Squash Center, equipment, or premise where MetroSquash takes place. 

Student noted above and his/her parent/legal guardian listed below shall save MetroSquash NFP, MetroSquash officers, directors, employees and agents and the participating clubs and organizations against any claims of injury, loss, damage of whatever nature (1) resulting from his/her participation in MetroSquash or (2) in connection with the student’s use of the MetroSquash Academic and Squash Center, equipment, or premise where MetroSquash takes place.

Permission to Use Photos
I, the undersigned, hereby give MetroSquash permission to use my child’s picture/photo in newsletters and 
other promotional pieces at the discretion of MetroSquash staff.

Emergency Consent
In the event of an emergency, I understand that MetroSquash staff will make every attempt to contact me and/or other persons named below who are listed as emergency contacts. In the event that I, and named persons on this form, cannot be contacted, I hereby give permission to MetroSquash staff to authorize such treatment as is necessary in an emergency for the health and well-being of my child.

Emergency Contacts:  I give permission to release my child into the care of the following person(s). Must be over 18 years old.

As the legal guardian of the child noted above, I give consent for all above agreements with my initials regarding liability, media use, and emergency contact.