Camp Application Form

Camp Application Form

Please complete this application in full. The parent or legal guardian must sign the acknowledgment and consents at the end of this form to register the camper for attendance. Incomplete applications may delay acceptance.

Camper Information

Date of Birth:

Gender: Male Female Other Prefer not to say

Parent / Legal Guardian Information

Emergency Contacts

Medical Information & Permissions

I authorize camp staff to administer prescription medication to my child as directed by the prescribing physician and in accordance with camp medication policies. Yes No

I authorize camp staff to administer over‑the‑counter medications (e.g., acetaminophen, ibuprofen, antihistamines) as needed per dosage guidelines. Yes No

Sessions & Payment

Select desired session(s). Fees are stated per session. A non‑refundable deposit is required to reserve a space unless otherwise noted in the camp’s fee policy.

Week 1: June 15–19 — Fee: $

Week 2: June 22–26 — Fee: $

Week 3: July 6–10 — Fee: $

Cancellation and Refund Policy: Deposits are non‑refundable. Requests for cancellation must be submitted in writing. Refunds, if any, will be processed in accordance with published camp policy and are at the sole discretion of camp administration.

Release, Indemnity & Acknowledgment

By signing below, Parent/Legal Guardian acknowledges and agrees that participation in camp activities involves inherent risks, including but not limited to physical injury, illness, and property loss. Parent/Legal Guardian voluntarily assumes all such risks on behalf of the camper and agrees to release, waive, discharge, and covenant not to sue the camp, its owners, directors, employees, representatives, volunteers, and agents (collectively, the Camp Parties) from any and all liability for personal injury, death, or property damage arising out of or related to camper’s participation, except for those arising from gross negligence or willful misconduct of the Camp Parties.

Parent/Legal Guardian further agrees to indemnify and hold harmless the Camp Parties from any claims, actions, suits, liabilities, damages, costs and expenses (including reasonable attorneys' fees) arising from or related to camper conduct, camper noncompliance with camp rules, or parent/guardian misrepresentations in this application.

Medical Treatment Consent: In the event of illness or injury, and if the Parent/Legal Guardian cannot be reached, the undersigned authorizes the Camp Parties to obtain necessary medical treatment for the camper. Such authorization includes transportation to a medical facility and consent to necessary medical procedures as determined by the attending medical professionals.

Media Release & Confidentiality

I grant permission for my child to be photographed, filmed, or recorded during camp activities and for such media to be used by the camp for promotional, educational, or administrative purposes in print or electronic media, unless I decline below.

I grant permission I do not grant permission

The camp will treat personal and medical information as confidential and will use and disclose such information only for purposes of enrollment, health and safety, and emergency response, unless otherwise required by law.

Acknowledgment

I certify that the information provided in this application is accurate and complete to the best of my knowledge. I understand and agree that failure to disclose pertinent information may result in dismissal from the program without refund. I have read, understood, and agree to abide by the camp policies, rules, and procedures as stated herein and as may be provided by camp administration.

Governing Law: This agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction where the camp operates, without regard to its conflict of law principles. If any provision is held invalid, the remaining provisions shall remain in full force and effect.

Entire Agreement: This form, together with any camp policies provided in writing, constitutes the entire agreement between the parties with respect to camper registration and supersedes all prior or contemporaneous oral or written agreements.

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