Camps Enrollment Application

CAMPS ENROLLMENT APPLICATION

Camp & Session Selection

Camp Program:     Session Name:

Session Start Date:     Session End Date:     Camper Grade/Age:

Student (Camper) Information

Date of Birth:     Student ID (if applicable):

Primary Phone:     Email:

Parent / Guardian Information

Relationship:     Phone (Primary):

Phone (Alternate):     Email:

Emergency Contacts & Medical Information

Relationship:     Phone:

Physician Phone:     Insurance Carrier:     Policy / ID #:

Immunizations current and on file:     Requires onsite administration of medication:

Tuition, Fees & Payment

Total Tuition: $     Deposit Amount: $

Pay Full Amount at Registration     Installment Plan (specify schedule)

Accepted Payment Methods:

Permissions, Releases & Policies

Photo/Video Release: I grant the camp permission to photograph and record the camper for use in program materials and promotional publications. I understand no compensation will be provided. Consent:

Transportation Authorization: I authorize the camper to be transported by approved camp staff or contracted carriers for scheduled activities and emergency transport. I acknowledge all transportation is at my own risk. Consent:

Administration of Medication: I authorize camp staff to administer or facilitate administration of medication as prescribed above or to provide over-the-counter medications per camp protocol. I will supply clearly labeled medication with written instructions. Authorization:

Behavior Policy Acknowledgment: I have read and agree that the camper will comply with camp rules and standards of conduct. The camp may dismiss the camper for failure to comply, without refund if dismissal results from the camper's conduct. Acknowledged:

Cancellation, Refunds & Financial Terms

Deposit is required to reserve a space. All cancellations must be submitted in writing. Deposits are non-refundable except as required by law. Refund eligibility for full tuition will be prorated based on enrollment date and camp incurred costs. The camp reserves the right to cancel a session; in such case, paid fees will be refunded or applied to another session at the family's election.

Release and Indemnification

In consideration of the camper's participation, I, on behalf of myself, the camper, and our heirs, release the camp, its employees, agents, and volunteers from liability for any injury, loss, or damage incurred during program activities, except to the extent caused by the camp's gross negligence or willful misconduct. I agree to indemnify and hold harmless the camp from any claims arising out of the camper's actions or omissions.

Certification & Authorization

By signing below I certify that the information provided is true and complete to the best of my knowledge. I authorize staff to act on my behalf in the event of an emergency and accept responsibility for payment of medical services. I acknowledge that failure to disclose relevant medical or behavioral information may result in dismissal without refund.

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