Summer Camp Registration
Event Timing:
Session 1: June 24th - June 28th 2024; 1:00 - 5:00 PM
Session 2: July 8th - July 12th 2024; 1:00 - 5:00 PM
Age Range: 6 -13 years old
Donation Amount: $175 per camper. Discounts: Two Siblings: $325; Three Siblings: $485
Event Address: 538 E. Main Street, Cottage Grove
Contact us at: 541-946-3132 or hannah@theguildinthegrove.com
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Email *
Primary Contact Full Name: *
This should be the adult that will be doing the majority of the communication, pick up, and drop off, or primarily responsible for the coordination of pickup/drop off.
Primary Contact Relationship to Child:
 *
Primary Contact Email *
Primary Contact Phone Number *
Additional Parent/Guardian Full Name:
Additional Parent/Guardian Relationship to Child:
Additional Parent/Guardian Email:
Additional Parent/Guardian Phone Number:
Emergency Contact Name *
Emergency Contact Phone Number: *
Child's Name: *
Child's Birthday: *
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Dates of Camp: *
Required
Dietary restrictions *
I understand that my spot is not reserved until my donation to The Guild in the Grove *
You will receive the donation link on the confirmation page of this form. Your spot will not be held until the donation is received. Donation Amount: $175 per camper. Discounts: Two Siblings: $325; Three Siblings: $485 
Required
Release of Liability Waiver:
 *

In consideration for being permitted to utilize the facilities and programs at Delight, the person completing this form, on behalf of themself and their heirs, minor child or children, ward, personal representatives and next-of-kin, does hereby agree to the following: 

The person completing this form hereby releases, waives, discharges and covenants not to sue Delight, its successors and assigns, and its directors, officers, employees, and agents (collectively, the Releases) from any and all claims, demands, damages, actions, causes of actions, or suits of whatever kind or nature arising or resulting from any loss or damage to property or injury or death to person, whether caused by the negligence of Releasees or otherwise, while they are in, upon, or about the premises of Delight or using any of its facilities, services or equipment, or participating in any program or activity offered by or affiliated with Delight.

The person completing this form hereby agrees to indemnify and hold harmless the Releasees and each of them from any loss, liability, damage, or cost they may incur, including but not limited to attorney fees, whether caused by the negligence of the Releasees or otherwise, due to his or her presence in, upon, or about the premises of Delight or use of its facilities, services or equipment, or participation in any program or activity offered by or affiliated with Delight. 

The person completing this form hereby expressly assumes full responsibility for and risk of bodily injury or illness, death or property damage, whether caused by the negligence of Releasees or otherwise, while they are in, upon, or about the premises of Delight or using any of its facilities, services or equipment, or participating in any program or activity offered by or affiliated with Delight. In the event of injury or illness, and if the emergency contact is not able to be reached in the amount of time needed to provide appropriate care, the undersigned hereby authorizes the Releasees to provide or cause to provide such medical care and treatment to them as may be necessary and appropriate. The person completing this form understands that they are solely responsible for all costs incurred for such medical care or treatment.

Required
Photographic Release Form:
 *
I grant permission to Delight,, its agents, and its employees the irrevocable and unrestricted right to produce photographs and video taken of my child, myself, and members of my family while at Delight for any lawful purpose including publication, promotion, illustration, advertising, trade, or historical archive in any manner or in any medium. I hereby release Delight and its legal representatives from liability for any violation or claims relating to said images or video. Furthermore, I grant permission to use the statements of my child, myself, or my family members given during an interview or evaluation with or without my name for the purpose of advertising and publicity without restriction to time limit or geographic area. I waive my right, my child’s rights, and my family’s rights to any and all compensation stemming from the use of these materials.
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