Welcome to the HAC Portal!

If you need assistance, please contact the Registrar, Mrs. Esther Keller at (216) 382-3300 ext.372 or email registration@hac1.org.

Application For Non 20-21 HAC Student

PLEASE NOTE: If your child is currently enrolled in HAC for 2020-2021, please apply for camp in the forms section of the parent portal. Please do not use this application.

Applicant

PLEASE NOTE: All K'tan Tan Campers MUST BE TOILET TRAINED to attend.

K'tan Tan Division Forms

Download

K'tan Tan Division Forms

Download

K'tan Tan Division Forms

Download

K'Tan Tan Division

Download

Current School



Parent Information


Father

Father's Spouse (if applicable)

Home Address



Mother

Mother's Spouse (if applicable)

Home Address




Other Information




Emergency Contacts

ALL EMERGENCY CONTACTS MUST LIVE WITHIN ONE HOUR OF SCHOOL. Parents cannot be listed as emergency contacts. Any person listed should be able to assist in contacting you. The people listed must be able to take responsibility for the child in case the parents cannot be reached and should be at least 18 years of age.

Emergency Contact 1
Emergency Contact 2

Physician


Dentist


Medical Condition


Food Allergies

What food(s) is your child allergic to?

Treatment Options


Seasonal Allergies

Treatment Options


Medication Allergies

Treatment Options


Epipen


Medications


Payment Information

Total Due: 

Please complete the payment information below. Camp charges for your child will be adjusted upon receipt of the County’s Placement Letter. Please contact Mrs. Malkie Neuman at neumanm@hac1.org or 216-727-3004 for any questions.
Please contact Mrs. Malkie Neuman at neumanm@hac1.org or 216-727-3004.
Please choose ACH or credit card. A 3% proccesing fee will be added when choosing the credit card option.


Consents and Signature

PLEASE NOTE: All registrations are final. No refunds can be provided. You will receive an acceptance decision within 2 weeks. Submission of this application does not guarantee acceptance into camp. Additionally, tuition balances need to be resolved before acceptance into camp.