ASL Summer Camp 2026

  • Camp Registration Form

    These forms are required for your children to attend camp.

  • Camper's Information

  • Date of Birth*
     - -
  • What are the TOP 3 reasons you would like your child to attend camp:*

  • THIS CAMP IS ONLY FOR DEAF/HARD OF HEARING, CODA'S, AND SIBLINGS OF DEAF/HARD OF HEARING.

  • Parents' Information

    Parent/Guardian 1
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Where would you like to be reached while your child is at camp?

  • Parent information

    Parent/Guardian 2
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Where would parent/guardian 2 like to be reached while your child is at camp?

  • Emergency Contacts/Authorized Pickup

    Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. The first emergency contact must be over the age of 18.

  • Information

    Emergency Contact #1
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Information

    Emergency Contact #2
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Medical / Health Information

  • Format: (000) 000-0000.
  • Does your child have any food, medication or environmental allergies?*
  • 0/150
  • Does your child’s allergy/allergies require child care staff to monitor child for symptoms, take action if a reaction occurs, or give emergency medication to your child?
  • Does your child have a special health or medical condition (including mental health issues)?
  • 0/150
  • 0/200

  • Medication

  • In the even your child needs medication, please check which medication your child can take.

  • I give permission for WVDSC to administer the above listed/selected medications to my child at camp.

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  • Photography

  • I give permission for WVDSC to share photos of my child on their website, Facebook, brochures, flyers, or other social media. 

  • Activity Consent

  • INFORMED CONSENT, RELEASE AGREEMENT, AND AUTHORIZATION: I herby give approval for my child's participation in all activities during WV Deaf Service Center's Summer Camp. In exchange for acceptance as a camper with WVDSC, I assume all risks and hazards incedential to paricipation in activities and release, resolve, hold harmless WVDSC and all it's respective staff, officers, agents, representatives, and volunteers from any liability from any injuries to said child arising from traveling to, participation in, or returning from selected camp sessions.

    In case of injury to said child, I herby waive all claims against the aforementioned parties including all staff, volunteers, affiliates, all participants, sponsoring agencies, advertisers, and if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all physical activity, including but not limited to: falls, breaks, scrapes, scratches, bruising, concussions, etc. 

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