Camper Information

Camp Information

Parent/Guardian Information

Emergency Information

Additional Information

Please notify staff if your child has been exposed to any communicable diseases in the 2 weeks prior to starting camp.

Participations, Release, and Medical Agreement

While we make every effort to provide a safe and pleasant environment for every camper who attends Ashlar, we do require that this participation agreement be read, filled out, signed, and dated by all campers (or their parent/guardian if under the age of 18) who wish to participate in activities at Ashlar. 

With full knowledge, I accept full responsibility for any injury or accident that may occur to myself, my spouse, or my child while participating in Ashlar activities. I give permission for my child to participate in activities that occur at Ashlar. These activities may include, but are not limited to, walking or climbing on rocks and logs, activities at the pond, hiking, campfire activities, interacting with chickens, and other outdoor activities in the forest and on the farm.

Although Ashlar has taken reasonable steps to provide equipment and skilled employees so yourself, your spouse, or your child can participate in activities for which he/she may not be skilled in, we do remind you that these activities are not without risk. Certain risks cannot be eliminated due to our camp's rural setting and without destroying the unique character of those activities. The same elements that contribute to the character of these activities can be cause of loss or damage to your property, accidental injury or illness or, in exteme cases, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for these activities, but we do think it is important for you to be informed and know in advance about inherent risks. 

I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless Ashlar, its officers, board, agents or employees, for any and all claims for injuries, causes of action, or liability related to my child's participation in any activity occurring at Ashlar. 

Should Ashlar, or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold Ashlar harmless for all such fees and cost. 

By signing this document, I acknowledge that if anyone is hurt or property damaged during my or my child's participation in these activities, I and/or my child may be found by court of law to have waived any right to maintain a lawsuit against Ashlar on the basis of any claim which has been released herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and agree to be bound to its terms. 

I give permission for myself or my child to attend camp at Ashlar. I understand that my personal insurance will provide primary coverage for medical aid. I also understand that if myself or my child must be sent home because of disciplinary or other problems, I will assume the additional transportation cost, and camp payments will not be refunded. IN CASE OF MEDICAL EMERGENCY, I hereby give permission to the physician selected by the camp director or agent to hospitalize, secure proper treament for, and order injection, x-ray, anesthesia, or surgery for myself or my child as named previously.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Camp registration is complete once this form has been submitted

and payment has been made.

Thank you!