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Math Club Registration Form


Who:  Students in grades 4-8
Date:  Every Tuesday starting October 19, 2021
Time:  3:15-4:15 pm
Location:  Coming soon

The Math Club uses materials from the California Math League, as well as plays games and engages in activities that involve number strategy and math facility. The club will be run by Dr. Xin Ai.  Please contact Student Life Coordinator, Activities, Mr. Derek McIntyre for any questions.

Student Information

Student's Namerequired
First Name
Last Name
Student's Graderequired

Parent Information

Parent's Namerequired
Prefix (optional)
First Name
Last Name

Parental Consent

In consideration of the named student being permitted to participate in ACDS after-school clubs and activities, we, the parents or legal guardians of the participant, on our own behalf and on behalf of the participant (hereinafter “Releasors”), hereby acknowledge and agree that we understand and fully appreciate the risk of injury involved to the student that is participating in clubs and activities. We understand that the camper will engage in various activities. The Releasors nevertheless hereby release, waive, and discharge Almaden Country Day School, its officers, employees, agents, counselors, and representatives, (hereinafter “Releasees”) from all liability to the Releasors for any loss or damage, and any claims or demands on account of injury to the student caused in any way while the student is participating in any of ACDS's after-school clubs and activities. The Releasors hereby agree to indemnify and hold harmless the Releasees, and each of them, for any loss, liability, damage, or costs and expenses including attorneys’ fees they incur due to the student's participation. It is the express intention of the Releasors to exempt and relieve the Releasees from any liability for personal injury, property damage, or wrongful death related in any way to the participation of the student in ACDS's after-school clubs and activities. The undersigned acknowledges that he or she is fully aware of the legal consequences of signing this application containing the express waiver and release of liability.

I, WE, the undersigned, parents of a minor,

do hereby authorize Almaden Country Day School's clubs and activities and its delegated leaders as agents for the undersigned to consent to any x-ray examination, anesthetic, laboratory, pathology, deemed advisable by, and to be rendered under the supervision of any physician, dentist, or surgeon licensed under the provisions of the medical staff of any licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. It is understood that this authorization is given in advance of any specific diagnosis or treatment and that reasonable effort shall be made to contact the undersigned prior to rendering treatment, but then any of the above treatments shall not be withheld if the undersigned cannot be timely reached. This authorization shall remain in effect unless revoked in writing.

By selecting the "I accept" box, you are signing the form electronically.required