Student Career Camp Intake

Student Career Camp Intake

Program Selection

Select the camp session(s) for which the participant is enrolling. Sessions may fill; selection here constitutes a request for enrollment and agreement to tuition terms below.

Student Information

Date of Birth:    Student ID (if applicable):

Parent or Guardian Information (if participant is minor)

Emergency Contact

Relationship:    Phone:

Medical Information & Health Authorization

The following information will be used by camp staff and medical personnel to provide appropriate care. Failure to disclose may limit care or require dismissal.

Primary Care Physician:    Phone:

Pickup & Transportation Authorization

Indicate who is authorized to pick up the participant. If no one is listed, the participant will only be released to the primary parent/guardian on file.

Transportation by camp staff or approved vendor: I authorize transportation for field trips and off-site activities.

Program Policies, Fees & Payment

Enrollment is subject to payment of tuition and completion of this intake form. By enrolling, the undersigned agrees to the camp refund, cancellation, and behavior policies described below.

Cancellation & Refund: Tuition refunds, if any, are determined by the camp's published policy. Fees may be retained for administrative costs; late withdrawals may be assessed partial or no refund.

Special Accommodations & Learning Needs

Career Interests & Statement

Consent, Acknowledgments & Releases

Activity Risk Acknowledgment: I acknowledge that participation in camp activities involves inherent risks, including but not limited to physical exertion, trips to off-site locations, and interactions with tools, equipment, or professionals. I accept responsibility for reasonable precautions and agree that the camp and its agents are not liable for ordinary negligent acts except as prohibited by law.

Emergency Medical Authorization: In the event of an emergency, I authorize camp staff to obtain and consent to emergency medical treatment for the participant if I cannot be reached. I consent to necessary transportation, hospitalization, anesthetic, and surgery as recommended by licensed medical personnel. I agree to be financially responsible for such treatment.

Medication Administration: I authorize staff to administer physician-prescribed medications and over-the-counter first aid/medications per camp protocol when necessary.

Photo/Video Release: I grant the camp permission to photograph or videotape the participant for promotional, educational, or archival purposes. I understand no compensation is provided and I waive rights to inspect or approve finished materials.

Transportation Consent: I authorize the participant to be transported by camp staff or approved vendors for program-related activities.

Code of Conduct: The participant will abide by camp rules and staff direction. Serious or repeated violations may result in removal from the program without refund. I accept responsibility for costs incurred due to misconduct.

Privacy & Records: The camp will maintain records necessary for participant safety and program administration. Personally identifiable information will be shared only with staff, medical personnel, or emergency contacts as reasonably necessary. Photographs may be used as described above.

Certification: By signing below I certify that the information provided is complete and accurate to the best of my knowledge, that I have authority to enroll the participant, and that I have read and accept the policies, consents, and releases contained in this intake form.

Acknowledgment Checkboxes

I acknowledge I have read and agree to the camp policies, including the refund and safety policies.

I certify that the medical information provided is accurate and complete.

Sign Now