2023 Camp Beyond Binary Camper Application

Camp Beyond Binary Camper Application
CAMPER/CAREGIVER INFORMATION:

Welcome to Camp Beyond Binary! This application will help us determine if you are the right fit for camp, and if camp is the right fit for you! Camper applications are reviewed on a rolling basis.

If you are accepted to camp, you will be sent a link for payment, a link to complete medical and emergency information, and a confirmation email with a welcome packet attached.

If you have any questions about this application or the process, please email us at Campbeyondbinary@gmail.com.

Please note: all campers and staff must be fully vaccinated against COVID-19 before August 6th, 2023.
Camper Information

Thank you for your interest in Camp Beyond Binary! We are so excited you are applying to attend! At Camp Beyond Binary we are committed to ensuring that our campers experience diversity across age, gender, race, and other factors. Because of this we ask that each camper fill out this application to the best of their ability, sharing as much information about themselves as they feel comfortable with. This will help us in program planning as well as camper selection.

Parent/Guardian and Camper Information

Help us give your camper the best experience!
Rate how comfortable you are with the out of doors 1 being "I'm freaked out by it" to 10 "I am one with the chipmunks and trees" *
It's your turn, parent/s or caregiver! Tell us about your expectations for camp.
What do you as a parent or guardian hope that your camper will gain from their camp experience?
How well does your camper relate to peers and adults?
Please list any concerns that you or your camper may have about camp:
Is there anything else you would like the camp staff to know about your camper?
Camper's Medical Information

Current health information is necessary for every camper who attends overnight camp, including a record of vaccinations. The Health History information must be current within 12 months of camp and should be completed by the parent or guardian. If your camper is accepted into camp, we will require a physical form, medication forms, and a current immunization record including dates of COVID-19 vaccinations by July 8th in order to attend camp. YOUR CAMPER MAY NOT ATTEND CAMP WITHOUT THESE COMPLETED FORMS. You be be emailed a link to these forms should your camper be accepted.
I agree to provide all medical information as described above by July 8, 2023. I acknowledge that my camper cannot attend camp without a complete medical history and immunization record.*

I agree
Photo Release

I hereby grant Camp Beyond Binary the irrevocable right and permission to use photographs and/or video recordings of my camper on the camp web site and other websites and in publications, promotional flyers, educational materials, derivative works, or for any other similar purpose without compensation to me.
I understand and agree that such photographs and/or video recordings of my camper may be placed on the Internet. I also understand and agree that I may be identified by first name, last initial and/or title in printed, Internet or broadcast information that might accompany the photographs and/or video recordings of me. I waive the right to approve the final product. I agree that all such portraits, pictures, photographs, video and audio recordings, and any reproductions thereof, and all plates, negatives, recording tape and digital files are and shall remain the property of Camp Beyond Binary.
*

I agree to the photo release as described above.I DO NOT AGREE to the photo release as described above.
Parent/Guardian Signature

Clear
Parent/Guardian Name

First NameLast Name
Should be Empty:

Camp Beyond Binary Camper Application

Camper Information

Camper Information

Parent/Guardian and Camper Information

Camper's Medical Information