2024 Fall Family Camp Registration

2024 Fall Family Camp Registration

Deposits/Payments will be received on Camp Website.
Family or Group Information:
Group or Family Leader Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone*

Area CodePhone Number
Secondary Phone

Area CodePhone Number
Primary Email*
Secondary E-mail
Emergency Contact (other than parent)*

First NameLast Name
Your Emergency Contact's Phone Number*

Area CodePhone Number
Vehicle Description (include make / model / color / license plate number)

Group Member Information:
List up to two children included in package with name, age, and gender.
List any additional family members with relationship, name, age, and gender.
($100 per additional person)
Package / Accommodations / Dates(s) / Activities:
Select Package*
Weekend Tent Camping Arrival Date (please call our office to verify availability)

MonthDayYear
Date
Included Activities
- Lake Canoeing
- Hiking/Fire Tower
- Creek Walks/Rock Slide
- Disc Golf (discs not provided)
- Picnic Lunch
- Camp Fire/S'mores

Please select staffed activities that you would like to add to your package ($80 1 hour Climbing Wall or Lake Zipline; $65/person for 1 hour trail/arena ride).

	Scheduled Activity
Lake Zip Line - Minimum 8 years old
Climbing Tower - Minimum 8 years old
Arena Horse Ride- Minimum 8 years old

We welcome additional requests or comments

Special Dietary Needs

VegetarianVeganFood AllergiesOther
Please explain any food allergies your family/group may have.
Please let us know of any other dietary considerations or preferences your family/group may have.
Please describe any other issues you feel we need to know for your family/group's health and safety while you're on site.
CONSENT FOR EMERGENCY MEDICAL TREATMENT I do hereby authorize the Camp Grier Director or such substitute as he may designate as our agent to consent to emergency medical treatment and hospital care for the above mentioned people. Such treatment must be deemed advisable by and rendered under the general or special supervision of any physician or surgeon licensed under the provision of the Medicine Practice Act or any dentist licensed under the Dentist Practice Act. This diagnosis or treatment may be rendered at the office of said physician or dentist, at a hospital, wilderness setting or elsewhere. Parent/ Guardian Initials:*
Date*
Liability and Waivers
GENERAL LIABILITY WAIVER AND RELEASE: Camp and adventure activities including, but not limited to, rock climbing, rappelling, hiking, biking, and wilderness travel, in general, have inherent risks. This document is an acknowledgment of those inherent risks. I recognize that good health is important to participate in activities at Camp Grier. I certify that I am in good health and have no physical or mental conditions which would endanger myself or others. I agree to consult a physician before engaging in any activity with an employee of Camp Grier if I have any doubt whatsoever about my physical or mental condition.

ACKNOWLEDGMENT OF RISKS: This document is an acknowledgment of those inherent risks which could result in injury, death, illness, disease, and damage to me or to my property and to others and their property. I voluntarily assume all known or unknown risks of participating in an outing led by Camp Grier. I am aware that those risks include, but are not limited to, risk of injury, paralysis, or death from falling, failure of equipment, reliance on others to belay, failure of anchors, holds or rock or ice fall, and my own or other’s failure to follow proper procedures, instructions of the guide, and use sound judgment. The above list is not complete or exhaustive and other risks known or unknown may also result in injury, death, illness, disease, and damage to me or to my property and to others and their property. I understand these risks and voluntarily assume all risks associated with this activity.

RELEASE, INDEMNIFICATION AND COVENANT NOT TO SUE: In consideration of hiring Camp Grier, I on behalf of myself, my heirs, legal representatives, and assigns hereby voluntarily release and covenant not to sue Camp Grier, its officers, agents, employees, owners, successors and assigns, from any cause of action, claim or demand of any nature whatsoever which relate to or arise out of my participation in a Camp Grier outing, clinic, or trip, including but not limited to the negligence of Camp Grier, its officers, agents, employees or owners. I also agree to indemnify and hold harmless Camp Grier, its officers, employees, owners and agents from any and all causes of action, demands, losses or costs (including attorney’s fees) of any nature which arise out of my participation in any outing, activity, or trip.

AGREEMENT TO FOLLOW SAFETY GUIDELINES: I accept full responsibility for my safety and the safety of others. I agree to abide by and help enforce the safety guidelines of any Camp Grier counselor or instructor and recognize that not all risks will be evident to a Camp Grier counselor or Instructor.

GENERAL: Camp Grier shall have the right to restrict or deny my participation in any activity or trip, restrict my access to certain terrain, and to exclude me from further participation at any time and for any reason. I further recognize that no representations or guarantees are being made to me by Camp Grier as to my own proficiencies, levels, attainment or my abilities to engage in similar activities without suffering injury or death in the future.

PHOTO RELEASE: I give permission for photographs to be taken of my child while participating in Camp Grier Activities. I agree to allow these photographs to be used in marketing/public relations materials and in the promotion of Camp Grier.

I HAVE CAREFULLY READ THIS FORM AND FULLY UNDERSTAND ITS CONTENTS. I UNDERSTAND THAT I HAVE GIVEN UP CERTAIN LEGAL RIGHTS AND THAT THIS IS A BINDING LEGAL DOCUMENT.
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2024 Fall Family Camp Registration

Family or Group Information:

Group Member Information:

Package / Accommodations / Dates(s) / Activities:

Liability and Waivers

Signature