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2023 Camp Registration Form
Please submit one registration per child. If you are submitting forms for multiple children, fill out the first form completely, then, on subsequent forms, you may enter quotation marks for any redundant questions.
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Please select one:
*
Session I: Nature Camp: June 26 - June 30 [Ages 5 - 10]
Session III: Wilderness Camp: July 19 - July 23 [Ages 15 - 18]
Camper's First Name
*
Your answer
Last Name
*
Your answer
Age
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At the time of camp
Your answer
Birthday
*
MM
/
DD
/
YYYY
Address
*
Your answer
Primary Parent Contact Information
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Please include the name, email, and phone number of a parent or guardian.
Your answer
Secondary Contact Information
If available, please include the name, email, and phone number of another parent or guardian.
Your answer
In the event of an emergency, please contact:
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Primary Parent Contact
Secondary Contact
Other:
Required
I, the parent and/or guardian, give my permission to Mountain Adventures to take my child to the hospital in an emergency situation.
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Submitting your name will serve as your electronic signature.
Your answer
Date of Signature
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MM
/
DD
/
YYYY
Please list any special instructions you want carried out in case of an emergency, including hospital preference.
Your answer
Allergies, Medications & Pertinent Medical History
*
Your answer
Swimming, Rock Climbing & Hiking Skills
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Briefly describe your child's abilities. Beginners welcome.
Your answer
Session II & III Only: Camping & Canoeing Experience
Briefly describe your child's camping and canoeing experience, if any. Beginners welcome.
Your answer
Photo Release
*
I hereby grant Mountain Adventures permission to use my child’s photograph taken during Mountain Adventures’ events, camps, field trips, and guided trips in any Mountain Adventures’ public display, website, newspaper or brochure.
Please do not use my child’s photograph taken by Mountain Adventures for any public display, website, newspaper, or brochure.
If there is anything else you'd like us to know, here is the place.
Your answer
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