Camp Shutter Speed Registration Form: July 11-15

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FOR MULTIPLE CHILDREN: Fill this form out for every child.

Registration for Camp Shutter Speed is considered first-come, first-serve. All payment for camp is due at time of registration. If you do not pay after/before completing this form, your spot will NOT be held until payment is made.

Email *

Child's Name *

Child's Date of Birth *

YYYY

Grade student will be entering in the 2022-2023 school year. (Must be entering grades 5-12) *

Parent/Guardian Name 1 *

Parent/Guardian Phone Number 1 *

Parent/Guardian Name 2 *

Parent/Guardian Phone Number 2 *

Child's Address *

Emergency Contact Name *

Emergency Contact Phone *

Please list all people the child may be picked up by including the phone number. (Note: Camp staff will only allow the child to leave with the people listed here, even if they are family members. We will have to call the parent/guardian listed if someone other than those listed here attempts to pick the child up.) *

Does your child take any medication regularly such as an Epipen? If so, please list those below.

Are there any other medical concerns that camp staff needs to be aware of? If so, explain below.

What camera will your child be using at camp? Please provide the brand and model (Ex: Canon Rebel T7, Nikon D780). If you do not have a camera, please note that a camera will be required before camp. We have referrals for rental companies and basic camera kits. Email us for details. *

Which of these generally is the best description your child's experience with photography and/or DSLR cameras? The more honest you are means we better prepare our activities to meet the needs of kids signing up! NOTE: The camp is designed for beginner to intermediate photographers. Advanced photographers are absolutely welcome but we will focus mostly in introductory knowledge and techniques. *

No experience at all other than cellphone camera

Little experience with DSLR/mirrorless cameras before, but has no idea what they're doing

Some experience with DSLR/mirrorless cameras before and knows a few things, but not much

Some experience with a DSLR/mirrorless camera before and knows the basics

Significant experience with a DSLR/mirrorless camera and knows a lot about settings and composition

Select all of the camera settings below which your child knows about. *

Aperture/f-stop

ISO

Shutter Speed

White Balance

Required

Has your child attended any photography camp before? *

Yes

If yes, explain their previous experience.

Has your child taken a photography class in school before? *

Yes

If yes, explain what course they took at what school.

I, hereby, give my permission for my child to be photographed by Camp Shutter Speed and understand that such photographs become property of camp and may be used for the purposes of marketing and our program. *

Yes

All participants must abide by all rules and regulations set forth by Camp Shutter Speed staff set while at camp and may be dismissed from the program at the discretion of Camp Shutter Speed staff without refund. *

I acknowledge the above rule.

REFUNDS. Once camp registration has been paid, a refund may be given for medical reasons only and a doctor's note will be required. Approved refunds will be issued two weeks following a refund request and will be issued in the form of a check. Approved refunds will be charged a $10 administration fee. *

I acknowledge the refund policy above.

Children will only be released into custody of parents or those listed on the release form. *

I acknowledge the policy above.

LIABILITY. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained by my child as a result of participating in the Activity, unless caused by the gross negligence or willful misconduct of the Camp Shutter Speed, its officers, trustees, agents, employees or volunteers (collectively referred to as the “Camp”). Liability Release. In consideration for the Camp allowing me to participate in the Activity, I agree I will not sue the Camp and I release the Camp from any and all liabilities, claims, demands, actions, causes of actions, costs and expenses of any nature whatsoever arising out of any loss, damage, or injury, including death, that may be sustained by me or to any property belonging to me, arising from the Activity or while upon the premises where the Activity is being conducted, excepting those claims arising from the gross negligence or willful misconduct of the Camp. INDEMNIFICATION. I agree to indemnify and hold harmless the Camp from and against any loss, liability, damage or costs, including court costs and attorneys’ fees, that the Camp may incur arising from my involvement in the Activity, excepting those claims arising from the gross negligence or willful misconduct of the Camp. EMERGENCY MEDICAL TREATMENT. I grant the Camp permission to authorize emergency medical treatment as it deems appropriate, and agree that such action by the Camp shall be subject to the terms of this Agreement. I understand and agree that the Camp assumes no responsibility for any injury or damage that might arise out of or in connection with such authorized emergency medical treatment. INTENT: It is my express intent that this Agreement shall bind the members of my family and spouse (if any), my estate, heirs, administrators, assigns, and personal representatives. I agree that this Agreement and any claim arising from my participation in the Activity shall be construed in accordance with the laws of the State of Texas, without regard to its conflict of laws provision. The courts in Montgomery County shall be the forum for any lawsuits arising from the Activity or incident to this Agreement. The terms of this Agreement shall be severable, such that if a court of competent jurisdiction holds any term to be illegal or unenforceable, the validity of the remaining portions of shall not be affected thereby. In checking the box below to agree to this Agreement, I acknowledge that I have read this Release Agreement form, understand it, and agree to be bound by its terms. I further acknowledge that I sign this Release Agreement voluntarily and I am at least eighteen years of age. *

I agree to the liability release agreement above.

LUNCH. I agree to provide my lunch everyday at camp and that camp will not be providing lunch. *

I agree.

SNACKS. While I will be providing lunch, camp staff may provide snacks as part of its activities. My child will be allowed to have snacks as part of these activities. *

Yes

SHOES. I agree to send my child to camp in closed-toed, non-slip shoes, such as a tennis shoe, for the safety of the child and the child's equipment. *

I agree.

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