Chauncy Fiddle Camp Registration Form

    This form must be submitted and payment must be mailed by April 1, 2023.
    Submit form and mail payment by March 1, 2023 to receive Early Bird discount​.
      By submitting this form you agree to the following:
    My child has permission to attend Chauncy Fiddle Camp sponsored by Elizabeth Anderson, held at 7 Chauncy St. in Westborough, MA from June 27-July 1, 2022 (Rain date July 2, 2022), from 9:00 a.m. to 2:00 p.m. (4:00 p.m. for extended day). I shall make sure my child does not attend if they are not feeling well or if they exhibit symptoms associated with COVID-19.  I will familiarize myself with and abide by camp policies for the prevention of COVID-19.  I understand that my child may be sent home if they exhibit symptoms or behaviors that are deemed to put other campers at risk.
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    1. In case of medical emergency, the adult in charge will attempt to contact a parent/guardian.  Your electronic signature below grants permission to the physician selected by the adult in charge to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for your child if we cannot contact you.  Your signature waives any responsibility for personal injury from Elizabeth Anderson, Janet Anderson, Benjamin Anderson and/or any other persons hired to help put on Chauncy Fiddle Camp.  Please indicate all medical information and restrictions on this form.

    2. Water activities are programmed daily for camp participants.  Please indicate below if you grant permission for your child to swim and boat with an American Red Cross certified lifeguard present.  Every precaution is taken to eliminate the risk of any injury to our campers; however, water activities carry certain risks, including drowning and death.  Your electronic signature hereby waives, releases, and holds harmless from any liability or claims for damages which may arise in connection to swimming or boating on Lake Chauncy, against Elizabeth Anderson, Janet Anderson, Benjamin Anderson, and/or     any other persons hired to help put on Chauncy Fiddle Camp.
    3. Photos and concert videos from camp may be posted for viewing online or used for promotional purposes.  Please indicate below if you grant permission for photos of your child to be used.
    Cost of camp is $310.

    Early bird rate of $290 applies if registration is received AND payment is postmarked by March 1.
    Please add $80 for Extended Camp and/or projected cost of morning supervision.

    If your plans change, a full refund is available if requested before April 1, 2023.
    75% refund is available if requested between April 1 and June 1, 2023.
    After June 1, a 75% refund is available if we are able to fill your place with another camper off the waiting list.  If we are not able to fill your place, no refund will be given.

    To complete your registration, mail check payable to Elizabeth Anderson to:
    Elizabeth Anderson
    21 Lancaster St.
    Quincy, MA 02169