Rumbling Bald on Lake Lure, Summer Camp Registration Form

We are thrilled to welcome you and your child to Rumbling Bald Summer Adventure Day Camp! Our program provides a safe, engaging, and fun environment for children during the summer, including activities such as sports, arts and crafts, nature exploration, field trips, and more.

Campers, ages 4-13, remain together all day, with separation only for age-specific activities (like sports days). Each day’s schedule includes age-appropriate rotations—swimming, games, crafts—plus extra focus on the featured activity listed on our camp calendar.

Important Notes

This form is not a reservation. Completing it does not guarantee a spot.
Reservations & Payments: Must be made by phone or in person at the Wellness Center during normal business hours.
Camp runs rain or shine.

Camper Information

Camper Name*

First NameLast Name

Camper Birth Date*

MonthDayYear

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name*

First NameLast Name

Cell Number*

Format: (000) 000-0000.

E-mail*

example@example.com

Membership/Lodging Requirement: Camp is open only to members and lodging guests.

Rumbling Bald Lodging Guest: type “LG”
Timeshare Owner (VRI): type “Timeshare”
Member #: Enter your Rumbling Bald member #
Associate #: Enter your Rumbling Bald associate #

Lodging Guest or Timeshare Owner*

Rumbling Bald - Member # or Associate #*

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Format: (000) 000-0000.

Alt. Phone Number*

Format: (000) 000-0000.

Does the camper have any allergies, chronic illnesses, or medical conditions? If yes, please describe.*

Is the camper prescribed an inhaler? If yes, please explain any instructions.*

Transportation & Field Trips

Off-property field trips require campers of certain age and heights to be in booster seats. All campers wear a seat belt in the van at all times.

Booster seats are provided for campers who need them.
Parents must provide a car seat if their child requires a rear-facing or forward-facing seat.

Yes, my child will need a booster seat.No, my child does not need a booster seat.

My child CAN be photographed.My child CANNOT be photographed.

Potty-Trained Acknowledgment

I verify my child is potty-trained and can use the restroom independently. Staff will not provide assistance. If it is determined that my child is not potty-trained, they will be sent home without refund.

Initial of parent/guardian*

Electronic Device Acknowledgment

No devices (phones, iPads, gaming devices, laptops) are allowed.
Devices brought to camp are not the responsibility of Rumbling Bald or staff.
Confiscated devices (if the device is causing a distraction) will be returned to the parent/guardian at the end of the day.

Initial of parent/guardian*

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities conducted by Rumbling Bald during the selected day/night. I agree that in exchange for my child’s participation in these activities, I will indemnify and hold harmless Rumbling Bald, its agents and assigns, board of directors, employees and any and all agents from any and all liability for injuries to said child or claims arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive any and all claims on behalf of myself or my child against Rumbling Bald including all counselors and 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 camp activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Initial of parent/guardian*

Medical Release and Authorization

As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional of the minor child, in the event of a medical emergency which in the opinion of the attending medical professional requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician or health care provider to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named minor. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every reasonable attempt will be made by the attending physician or health care provider to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Rumbling Bald and its affiliates including Directors, counselors, employees and other staff members to provide the needed emergency treatment prior to the child’s admission to the medical facility.

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, in my absence.

Child's Name*

Initial of parent/guardian*

Member Card & Guest Passes

A valid Member Card or Guest Pass is required at drop-off.
Campers ages 12–13 must also present their own card or pass.
Failure to provide these items will prevent attendance for the day, no refund issued.

Cancellation Policy

All cancellations must be submitted by email to mjohnson@rumblingbald.com.

Cancellations made at least 48 hours prior to the camper’s start date will receive a 50% refund.

Cancellations made within 24 hours of the camper’s start date will not be eligible for a refund.

If a camper does not attend camp and no cancellation notice is provided (“no-show”), the registration will be non-refundable.

However, if a camper must cancel due to a medical reason, a full refund may be issued with written verification from a doctor, provided the documentation is submitted before the camper’s start date.

In order for your child to attend Rumbling Bald Summer Camp, this form must be completed prior to reservations. Payment, in full, is required at the time of booking. *

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature*

Date*

Date