2024 QUEER CAMP REGISTRATION
Welcome to your week-long summer youth day camp where LGTBQIA+ youth and allies can feel safe, celebrated, loved, and valued by each other and their community. It offers you a unique opportunity to let loose and have fun being who you are without any hesitation or fear of judgement. It's a perfect setting to meet new people and make new connections for youth, their families, and their wider networks. The camp is staffed by numerous LGBTQIA+ adults who want to provide a fantastic experience for LGBTQIA+ youth. More information is available here: www.queer.camp/about.

This is a day camp for middle school, junior high, and high school students (ages 12–18) and will run from Monday through Friday (July 8-12), 10 a.m. to 6 p.m.

Payment Information: Queer Camp early registration costs $200 per camper paid by June 1st, 2024. Late registration from June 2nd through July 1st costs $225. 

You may mail a check. Or you may pay online at: https://bit.ly/queercamp24. Be sure and put the name of the camper in the memo line of your check or in the blank text box if making your payment online. Please email queercampnwa@gmail.com to ask for a need-based scholarship. Limited scholarships are available. Deadline to register is July 1st, 2024.

Contact us with any additional questions at: 
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Email *
Camper's Preferred Name (First and Last) *
Preferred Pronouns *
Campers Date of Birth *
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Grade completed at end of 2023-2024 school year
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Camper's email
Parent/Guardian’s name (first and last)
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Parent/Guardian’s full mailing address
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Parent/Guardian’s phone number (include area code)
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Parent/Guardian’s email
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Emergency Contact’s first and last name
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Emergency Contact’s phone number (include area code)
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Is anyone other than Parent/Guardian allowed to pick up camper? If so, please list their names and phone numbers. If no, please write N/A. Anyone picking up a camper, including parent/guardian, will be required to show a photo ID.
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Is Camper is a licensed driver who will be driving themselves to and from camp?
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Does the camper have any of the following allergies or medical conditions *
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If you checked any of the above boxes, please give details here:
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Please list any dietary restrictions or food allergies.
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Please list any medications your camper might bring with them to camp. Example: Epi-pen, inhaler, etc. If there are none, write N/A. Please list dosage, frequency. Ensure that all pills are in original prescription bottle.  
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Is the camper allowed to use insect repellent or sunscreen? *
Is your camper allowed to receive a free haircut? *
Camper's Teeshirt Size *
Are there any physical, emotional or spiritual needs our staff should know about?
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How did you learn about Queer Camp?
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WAIVER AND RELEASE: I understand that some camp activities have inherent risks. My child has permission to participate in the camp activities at Queer Camp/Good Shepherd Lutheran Church. I understand that reasonable measures will be taken to safeguard the health and safety of all participants and that I will be notified as soon as possible in case of any emergency affecting my child. In the event that I cannot be reached in an emergency, I hereby authorize my child’s emergency contact to act on my behalf. Furthermore, if the emergency contact nor I can be reached, I authorize Queer Camp/Good Shepherd Lutheran Church to select a physician and/or hospital to provide emergency medical and surgical treatment and to provide routine health care; to administer medications; to order x-rays, routine tests, treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation. I understand that my insurance is the primary coverage. I understand that my child can be dismissed from camp for reasons including, but not limited to: chronically disruptive behaviors, illegal activity, persistent breaking of camp rules, emotional or physical abuse of another camper or staff member, contagious illness, or destruction of property. Acknowledging that participation in camping programs carries with it the risk of injury, I agree that Queer Camp/Good Shepherd Lutheran Church, their agents and employees shall not be liable to me or my child for any injury or damage, howsoever caused, resulting directly or indirectly from my child’s participation in Queer Camp at any time preceding, during, or after camp is in session. I hereby discharge Queer Camp/Good Shepherd Lutheran Church, their agents and employees from all actions, claims, and demands my child or I may have for any such injury or damage. I hereby grant permission to the director and his/her staff and screened volunteers to involve my child in adventure/group building activities, as part of the regular camp program and grant permission for my child to go on camp field trips if driven by a licensed, insured and screened driver.
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My child has permission to ride with a Queer Camp staff member to Arkadia Retrocade should they chose to participate in that activity. *
Photo and video waiver: Queer Camp/Good Shepherd Lutheran Church is respectful of your privacy and the use of photographs and videos taken during the camp session. If you are comfortable with photos and videos being used for social media or for promotional/educational materials, we ask that you agree to the following. Please note this is not required for participating in the camp. We also ask that all campers be respectful of other campers’ privacy in taking and posting photos. By checking yes, you authorize Queer Camp/Good Shepherd Lutheran Church to have the right to use photographs or videos taken during camp for social media or promotional/education materials.
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Parent/Guardian: By typing your full name, you acknowledge the information provided by you on this form is complete and accurate.
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A copy of your responses will be emailed to the address you provided.
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