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* Photo Upload (.jpg, or .png) (up to 2MB)
* Category Deree Fitness Deree Sports Academy Summer Camp
* Sex Male Female
* Last Name
* First Name
* Date of birth
* Address
* Zip (no spaces)
* Area
* State
* Country
* Parent 1 Last & First Name
* Parent 2 Last & First Name
Guardian's Last & First Name
* Parent 1 Email - Contact
Parent 2 Email
* Email
* Mobile - Contact
* Emergency Phone
Financially Liable Parent 1 Parent 2
* Tax registration number of financially liable
* Tax Number
Car's plates
Pierce student ID# (e.g. 123456-1)
Parent Alumni
Deree student
Alba student
Pierce Alumnus/a
Deree Alumnus/a
Alba Alumnus/a
Staff/Faculty ACG
ACG Retiree
DCAC Staff
Pathologist or Cardiologist Upload (.pdf, .jpg, or .png) (up to 2MB) X Remove File
Dermatologist Upload (.pdf, .jpg, or .png) (up to 2MB) X Remove File
Pediatrist Upload (.pdf, .jpg, or .png) (up to 2MB) X Remove File
I hereby provide my consent for the processing of my contact details by the Athletic Club and ACG, in order to receive information on future programs, news and events of the Athletic Club and ACG. Yes No
I hereby provide my explicit and unreserved consent, as holder of parental responsibility of the participant, for the presentation of commemorative photos and videos in which my child appears, along with other participating children, on the websites of the American College of Greece and the Athletic Club or in other promotional material (documents, posters, online videos, social media accounts of the College and the Club etc.) for a time period of 5 (five) years, for the purpose of promoting and informing the public regarding the activities of the Athletic Club, subject to the above conditions. Yes No
* I have been informed of the aforementioned processing of my personal data and of the participant’s personal data, and I hereby provide my explicit and unreserved consent, individually and as holder of parental responsibility, to the processing as specifically described in the Personal Data Consent. I have read and agree with the Rules of Participation of the Deree Sports Academy. I, in my capacity as Parent/Guardian-Registration Administrator, declare that all information concerning myself, the program participant (my child) and Parent/Guardian 2 as completed in this online form is true and accurate. In case of changes, I understand that I am expected to notify Deree College Athletic Club without delay and in writing to the following e-mail address: dcac@acg.edu. * I have been informed of the aforementioned processing of my personal data and of the participant’s personal data, and I hereby provide my explicit and unreserved consent, individually and as holder of parental responsibility, to the processing as specifically described in the Personal Data Consent. I have read and agree with the Rules of Participation of the Pierce Summer Camp. I, in my capacity as Parent/Guardian-Registration Administrator, declare that all information concerning myself, the program participant (my child) and Parent/Guardian 2 as completed in this online form is true and accurate. In case of changes, I understand that I am expected to notify Deree College Athletic Club without delay and in writing to the following e-mail address: dcac@acg.edu. * I have been informed and I hereby provide my consent for the processing of the mentioned data of the Personal Data Consent Form. I have read and Ι agree with the Rules of Partitipation of the Deree Fitness Program.
* Parent/Guardian-Registration Administrator Name
* Parent/Guardian-Registration Administrator Surname
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