If you are registering a child
for one (1) week of Summer
Festival, payment is due in full
at time of registration.
If you are registering a child
for multiple weeks of Summer
Festival, a minimum deposit of
$100.00 per child is due with
registration and full payment is
due no later than May 27, 2016
Again this year, we will offer registration forms on line!
To register for Summer Festival 2016,
Please print the following forms.
Each family will need:
Page 1 (Summer Festival Registration) (1) per family
Page 2 (1) for each child
Page 3 (Extended Day) (1) per family(if needed)
Please enclose a copy of a current utility bill if your family is
a NEW Summer Festival Participant to verify Taunton residency.
Forms received without payment will not be processed.
Openings in Summer Festival are on a first come, first served basis.
For confirmation on enrollment, please clearly print your e-mail address.
If you have any questions or concerns, please e-mail:
**********************
Mail completed forms along with check or money order to
Summer Festival
170 Harris Street
Taunton, MA  02780
After initial deposit is made, you will be sent information to pay any balance due on line by check or c
redit card using the City of Taunton’s secure site.
Summer Festival Registration - 2016
Child’s Name:__________________________  Date of Birth:  _____________Age:___
Child’s Name:__________________________  Date of Birth:  _____________Age:___
Child’s Name:__________________________  Date of Birth:  _____________Age:___
E-Mail Address: (please print clearly)    _____________________________________________________________ Mailing Address:_____
________________________ City:______________ Zip: ________ Home Phone Number:_____________________  Cell Phone: _______________________
Parent Information:
register for(Father’s Name)__________________________Day Time Phone Number:_________________________                (Mother’s Name)_________________________Day Time Phone Number:_________________________ Emergency Name And Number of Someone Who Will Be Allowed to Pick up Your Child
In the Event A Parent Cannot Be Reached:
Name: __________________________________Relationship to Child/ren:_________________________ Address:_________________________City:_______________Phone:_____________________________
************************************************************************************* You must provide transportation to and from Hopewell Park.  Please list any individual in addition to
those named above that will be allowed to pick up your child/ren.
Name Relationship Phone Number
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________ Children will not be allowed to leave with anyone not listed above without written authorization of a parent/legal guardian.
I give my child/ren named above permission to participate in the 2016 Summer Festival Program sponsored by the City of Taunton and do hereby consent to his/her participating in recreational programs and do forever RELEASE, acquit, discharge,
and covenant to hold harmless the City of Taunton from any and all actions, causes of action, [and] claims on account of, or in
any way growing out of, directly or indirectly, all known and unknown personal injuries or property damage which I may now
or hereafter have as the parent/legal guardian of said minor, and also all claims or right of  action for damages which said
minor has or hereafter may acquire, either before or after he/she has reached his/her majority resulting from his/her
participating in the City of Taunton’s Recrea tional Program.
Photography Consent
It is possible that pictures may be taken during programs.  I grant permission for pictures taken during program hours to potentially be used for promotional purposes - (newspaper, website, flyers, facebook,etc)  If NOT state NO here:  ________
I understand that if my child is not picked up by 3:30 PM SHARP, (5:15 PM if enrolled in extended hours) I will
be charged a $15 late fee per child payable to the City of Taunton.  If this should happen more than once, the
result could be termination from the program and no fees will be refunded.
Signed:________________________________________
Relationship to Participant: _________________________ (Must be Parent or Legal Guardian)
Summer Festival Registration - 2016
Child’s Nam e: _____________________________  Age:_____ Preferred Name: ___________________________
School Attended: ______________________  Grade Completed (June 2016)__________
1.Does your child have any physical limitations, conditions, or allergies that we should be
aware of?  If so, please indicate below, or state NONE.
_____________________________________________________________________________________ 2.  Is your child currently taking any medication?  If so, please indicate the name of
medication and reason below or state NONE.
_____________________________________________________________________________________
Please Note:  We are not allowed to administer any medication while your child is enrolled.
3.Is your child in a Special Education Program at school?  Is a 1:1 aide required at
school?  Any problems or issues with hearing/speech/behavior?
_____________________________________________________________________________________
**  On Full Day Trips the Summer Festival will be open only to those who will participate in the weekly trip.  No additional fees will be charged for the trips.
Extended Hours - Will your child require early drop off (before 8:30 AM) or late pick-up
(after 3:30 PM)      ______ NO        ______ YES  please complete Extended Day Application
T-Shirt Size: Youth _____ (Small 6-8,    Medium 10-12,    Large 14-16)
Adult _____  (Small 34-36, Medium 38-40,    Large 42-44,    X-Large 46-48)
************************************************************************************* Please indicate weeks enrolling in:
_____(#1) June 27 – July 1  _____(#2) July 5 - 8        _____(#3) July 11 - 15        _____(#4) July 18 - 22  Legoland                          Plymouth Cruises Movies & Carousel                                        Colt State Park
(No Program July 4th)
_____(#5) July 25 – 29        _____(#6) Aug. 1 – 5  _____(#7) Aug. 8 – 12    _____(#8) Aug. 15 – 19
NE Aquarium Water Wizz                                  Paw Sox Game                                    Canobie Lake Park
***************************************************************************************** Office Use:
Total Due: ____________
Amt Paid @ Registration:___________  Ck# & Name ___________________
Balance Due:__________  2nd Payment: ____________  Ck# __________  Paid in Full
MOCD
Summer Festival 2016
Extended Day
Child’s Name _______________________________________Age ____________ * Extended day hours do not begin until 6:45 AM and end at 5:15 PM sharp. *
Fee Schedule:
AM Only (6:45 am - 8:30 am)          $25.00 Per Child Per Week (or $7.00 a day)
PM Only (3:30 pm - 5:15 pm)  $30.00 Per Child Per Week (or $8.00 a day)
Both AM & PM $40.00 Per Child Per Week (or $10.00 a day)
My child will be enrolled in: Please check week and circle AM and/or PM, and weekly or daily
____ Week #1 (June 27 – July 1)      ____ Week #2 (July 5 - 8)                  ____ Week #3 (July 11 - 15)
AM    PM                                          AM    PM                                          AM    PM
Full Week      Full Week                                        Full Week
Daily:  M  T  W  Th    F                    Daily:  M  T  W  Th  F                    Daily:  M  T  W  Th  F
____ Week #4 (July 18 - 22)        ____ Week #5 (July 25 – 29)                      ____ Week #6 (Aug. 1 - 5)
AM    PM AM    PM                                              AM    PM
Full Week      Full Week                                        Full Week
Daily:  M  T  W  Th  F                    Daily:  M  T  W  Th  F                      Daily:  M  T  W  Th  F
____ Week #7 (Aug. 8 – 12)    ____ Week #8 (Aug. 15 - 19)
AM    PM AM    PM
Full Week              Full Week                                                                                    Daily:  M  T  W  Th  F Daily:  M  T  W  Th  F
Expected Drop-Off Time _________
Expected Pick-Up Time  _________
I understand that if my child is enrolled in extended pm care and is not picked up by 5:15 PM sharp, I will be charged a late fee of $15.00 per child and that if this should happen more than once, the result could be termination from Summer Festival and no fees will be refunded.
X___________________________________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Office Use Only:
Total Due:_________          Amt. Paid __________            Ck # & Name ______________________

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