2022 Beach Camp Summer Program Application/Registration Form

Student Information

Parent - Primary Contact

Secondary Contact (If we can't reach the primary)

Informed Consent Waiver and Release

By signing below I acknowledge that I am the parent or legal guardian of the Student being registered, I have reviewed the materials on the Beach Camp website including activity videos and ackknowledge the risks inherent in the Beach Camp program including but not limited to classroom instruction, overnight accomodations with other participants and staff, swimming, diving, sailing, kayaking, canoeing, paddleboarding, outboard powered Zodiacs, biking, skateboarding, skimboarding, snorkeling, snuba/bubbleheads, ziplines, rope swings, ninja obstacle courses, beach and wilderness hikes, camping, and other outdoor and water related activities, and I hereby give my permision and approval for the above referenced Student's participation.

In exchange for acceptance of the Student's registration and attendance, I agree to assume all risks and hazards which may arise, and agree to release from liablity and to defend and indemnify against such liablity, all persons and entities providing, or involved with providing the Beach Camp programs as well as owners of property upon which the programs operate. These released persons and entities ("Releasees") include but are not limited to Beach Camp LLC, Sunset Bay Wharf, Save Our Shorelines, SSB Properties Inc., and the City of Edmonds, and each of the forgoing's owners, officers, employees, volunteers, helpers, guests, agents, representatives, and parent, subsidiary, successor and affiliated persons and organizations.

This application and registration also constitutes permission for use of photo and video recordings of said Student by Beach Camp and its sponsors and affiliated entities in advertising and promotion of Beach Camp programs and related activites and events.

Medical Release and Authorization

As Parent and/or Guardian of the named Student, I hereby authorize the rendering of first aid for said student in the event of a medical emergency which in the opinion of Beach Camp staff requires immediate attention to prevent further endangerment of the Student's health, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted for attending medical personnel to proceed with medical treatment for said Student. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made to contact me in the most expeditious way possible and this authorization presumes reasonable effort will be made to reach me if time permits.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child Student, in my absence.

Agreement Confirmation

BY SELECTING "SUBMIT FORM" AT THE BOTTOM OF THIS PAGE I AM AGREEING TO ALL TERMS AND CONDITIONS SET FORTH HEREIN, AND AGREE THAT THIS SUBMISSION CONSTITUTES DELIVERY OF AN ELECTRONIC SIGNATURE WHICH HAS THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE, AND THAT THIS ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Payment Section

Overnight Camp - 1. Select your program and camp store credit; 2. Click the "Payment Method" button below; 3. Enter your cc information; 4. Click "Submit Form" 

**Overnight forms submitted without payment will not secure your spot**

Daycamp (Minnows & Seals only) - 1. Select camp store credit and enter cc info or just click "Submit Form"; 2. Wait for the "Submission Received" screen; 3. Go here to make your tuition payment on the Edmonds Park & Rec Reczone website:

https://anc.apm.activecommunities.com/edmondsparksandrec/activity/search?onlineSiteId=0&activity_select_param=2&viewMode=list 

Day Camp spots are secured by the City's acceptence of your payment.