Panorama Registration Form

Please enter a value between 6 and 11.

Please enter a value between 6 and 11.

Please enter a value between 6 and 11.

Please enter a value between 6 and 11.


If parent/guardian is not available in an emergency.

If parent/guardian and Second Emergency Contact is not available in an emergency.


Please send medication for allergic reactions with child to first day of program. **Children must be able to administer their own medications with adult supervision.**

Note: All medications are to be sent in their original containers. **Children must be able to administer their own medications with adult supervision.**

I hereby grant permission to New York State, its agencies and assigns to use my dependent(s) photograph on their World Wide Web sites or in other official printed publications without further consideration, and I acknowledge the aforementioned reserve the right to crop or treat the photograph at their discretion. I also acknowledge that New York State, its agencies or assigns may choose not to use my photo at this time, but may do so at its own discretion at a later date. I also understand that if my image is posted on a website maintained by New York State, Its agencies or assigns, the image can be downloaded by any computer user. Therefore, I agree to indemnify and hold harmless from any claims New York State, its agencies and assigns.


I, as a parent or legal guardian, authorize my child to participate in Panorama, Olana's summer program at Olana State Historic Site, which may include use of equipment, use of facilities, and necessary preparatory activities. I further relase Olana State Historic Site its employees and assigns from any and all liability for personal injuries and/or property damage sustained by my child, or any claim which I may have as parent/guardian, arising directly or indirectly in connection with this program, except in the case of negligence. In case of injury I authorize Olana/Staff to take my child to a doctor or to a hospital for treatment. This authorization and release is valid for July 6-24, 2020 unless withdrawn by me in writing, which withdrawal shall be effective at the time of the receipt by Olana State Historic Site.


To complete payment, please use our purchase link on the next page, or mail a check to: TOP Education PO Box 199 Hudson, NY 12534