2023 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 the following: Communicable diseases including Covid, parking and crossing parking areas, roadways and railroad crossings, beach combing, swimming, diving, sailing, kayaking, canoeing, paddleboarding, outboard powered Zodiacs, biking, e-bikes, skateboarding, skimboarding, snorkeling, snuba/bubbleheads, ziplines, rope swings, ninja obstacle courses, team sports, clam digging, crabbing, fishing, boatbuilding, creek walks and wilderness hikes, other outdoor and/or water related activities, overnight accomodations, camp provided food and refreshments. I hereby give my permision and approval for the above referenced Student's participation and encountering of these risks and others associated with the Beach Camp program. 

In exchange for Beach Camp's acceptance of the Student's registration and attendance, I agree to assume all risks and hazards of accidents or injury, including property loss, bodily injury and death, which may arise from any cause, and agree, on behalf of myself and my heirs, executors, and administrators, to waive and release any and all rights, claims, and causes of action, and to release from liability and to defend and indemnify against such liability, all persons and entities providing, or involved with providing, the Beach Camp programs, as well as the 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. I attest that I have read, fully understand, and agree to this assumption of risk, waiver of liability, and release of all claims.

 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 the Program 2. Click the "Payment Method" button below; 3. Enter your cc information; 4. Click "Submit Form" 

*Forms submitted without payment will not secure your spot*

**Second Half Payment and Camp Store Credit Links will be sent to you as your camp week approaches**

***This deposit is non-refundable. You must purchase separate trip cancellation insurance to obtain cash refunds. Week changes are accomadated on space available basis.