2022 Young Adults Retreat

Please note: you must fill out this form completely, click "Submit", and process payment (or select "paying by check") in order for your registration to be received. Your progress will not be saved if you exit the form before submitting.

Contact Information

Name *

First Name Last Name

Gender *

Male Female

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number *

Area Code Phone Number

Email *

example@example.com

Age *

Is this your first time at Trail Ridge?

Yes No

If so, how did you hear about camp?

Do you regularly attend a church? If so, where?

Do you have any dietary requirements due to allergies or medical conditions that our kitchen should be aware of? *

Do you have any physical conditions we should take into consideration?

In consideration of attending Trail Ridge Camp Inc. (“Camp”) and participate in Camp programming and activities, I ("Camper") agree:
I. AUTHORITY AND RESPONSIBILITY FOR CAMPER
I understand, represent, warrant and agree that:

I release and indemnify Camp, its agents and employees and any others associated with the camp from any and all claims and liability to or in relation to Camper for any damages or injuries which may be sustained by Camper resulting from the Camp’s reliance on my authority and representations provided in the Medical Authorization, Media Authorization or other provision of this agreement.

II. MEDICAL AUTHORIZATION

Camper’s health information and history provided on Camper’s Health Form is correct and accurately reflects Camper’s health history and current condition.
Unless specifically noted on the Health Form, Camper is in good health and able to participate in all camp activities.
In event of emergency or urgent situation, Camp is authorized to obtain and transport Camper for care to the Camp Physician or other emergency care provider. I further authorize the Camp Physician or such provider to hospitalize, secure proper treatment, and order injection, anesthesia, or surgery for the Camper, including x-rays and routine and emergency tests and examinations.

III. MEDIA AUTHORIZATION

Camp is authorized to create and use Camper’s likeness, actions, statements in any live or recorded audio, video, photographic, or other medium of display, transmission, exhibition, publication or reproduction of Camper present at or participating in any Camp location, programming or activity (“Camper Media”).
Camper Media shall be only for Camp purposes, programming and activities including, without limitation, for maintaining internal records and documentation and for advertising, marketing and other communications.
Camp’s use of Camper Media as authorized shall not constitute an invasion or breach of Camper privacy.

Signature

Clear

Registration Fees- Pay with Card

Young Adults Retreat--Single $ 60.00

Donation to Camp $ 1.00

Enter amount you wish to donate

Total $ 0.00

Select this box if paying by check. Checks must be mailed and postmarked no later than Wednesday, September 14, 2022. Registration is not finalized until payment is received.

Paying by check

2022 Young Adults Retreat Registration - Single