Fall Retreat Camper 2023 Registration

Fall Youth Retreat 2023 Camper Registration

Grades 6-12; October 20-22, 2023
Important Instructions

Welcome! We are so excited to welcome you camper to La Foret this year.

If you are registering as an adult, do NOT use this registration form. Email camp@laforet.org for a counselor registration link.

Please note that this form MUST be filled out by the camper's legal guardian. We need to have the best contact email for you, so we can send you a confirmation email and important updates.

At the bottom of each page is a "save" buton which allows you to save your progress and come back later. Please note that if you select this option the system will require you to enter an email and password so you can log back in later.

If someone other than the parent/guardian filling out this form will be completing the payment, you will have to save your progress on the last page, and then forward the email the system sends to you, to the person completing the payment.

If you have any questions, feel free to contact us at camp@laforet.org or 719-822-7243
Camper Information
Camper's Legal Name*

First NameLast Name
Preferred Name or Nickname
Optional
Camper's Birthday*

MonthDayYear
Date
What is the camper's grade level in school?*
Camper's Gender*
Camper's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name*

First NameLast Name
Primary Email (required for confirmation and event communication)*
example@example.com

Camper Profile

Our camp staffs work in covenant with you, the parents/guardians of the children attending camp. The more information you supply about your child, the better the staff can prepare for their presence in camp and ensure a successful experience for all. This information is treated as confidential and is shared on a need-to-know basis only among those working with the specific camp your child is attending. Thank you for your understanding and partnership.
Camper History
Has this camper been to La Foret before?*
If the camper has been to La Foret before, about how many years?
If a first time camper, how did you hear about us?
Restrictions and Exclusions

Optional
Does your child have any restrictions on activity?
Please explain here what activities must be restricted and list any special accommodations needed
Overnight Considerations

Optional
Please list any information you would like to share about your child's sleeping habits or routines:
Do you anticipate any issues with your child being away overnight at camp?
Cabins and Gender: Camp naturally includes sharing sleeping rooms with other campers. The bathrooms in our cabins are completely private for changing and showering. Campers are also not permitted to change in bedrooms with others present. Because private bedrooms are not part of the camp experience, please list here the camper's preference about the gender identity of their roommates.
Any concerns or instructions related to your child's gender identity?
(pronouns, preferred name...)
Social Abilities

Optional
Please list here any information you wish to share about your child's ability to interact socially:
Additional Comments

Optional
What are your hopes for your child by attending this outdoor ministry event?
Do you have any concerns you would like to share?
Anything else you would like to add?

Pickup Authorizations and Emergency Contacts
Pickup Authorization

If our counselors do not know the person picking up a camper well, we will ask for a photo ID. Only those with a photo ID and a name listed below will be allowed to pick up your child.
Names of those authorized to pick up:*
Contact information of those authorized to pick up:*
If we do not have the phone and/or email for authorized pickup people, we will call the parent/guardian directly during pick up.
Who is specifically NOT authorized to pick up your child after camp?
This field alerts camp staff to specific family/personal situations to ensure camper safety.
Emergency Contact #1
Name*

First NameLast Name
Relationship to Camper*
Primary Phone*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Emergency Contact #1 Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact #1 Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact #2
Name

First NameLast Name
Relationship to Camper
Primary Phone
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Emergency Contact #2 Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact #2 Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Household Form

The purpose of the Household Form is to gather information about the camper's family and home for legal, contact, and reference purposes.
Parent/Guardian Demographics
Name of Adult #1*

First NameLast Name
Phone for Adult #1*
Please enter a valid phone number.
Email for Adult #1*
example@example.com
Home Address for Adult #1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMPLOYER Address for Adult #1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMPLOYER Phone for Adult #1
Please enter a valid phone number.
EMPLOYER Email for Adult #1
example@example.com
Name of Adult #2

First NameLast Name
Phone for Adult #2
Please enter a valid phone number.
Email for Adult #2
example@example.com
Home Address for Adult #2 (if different from Adult #1)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMPLOYER Address for Adult #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMPLOYER Phone for Adult #2
Please enter a valid phone number.
EMPLOYER Email for Adult #2
example@example.com
Family Status of Parent(s)/Guardian(s)*
Custody (if applicable)
Church Affiliation: We recognize that many of our campers are not associated with the United Church of Christ or any church. For those who are, this information helps us stay "radically connected" to the Rocky Mountain Conference.

Medical Information and Authorizations

All campers registered in children's camp programming, (including those who have turned 18) are required by State Law to have their medicine supervised by the health care provider. At the providers discretion, some medicines may remain with child (usually epi-pens, inhalers, lotions, eye drops, etc) ALL pills, prescription and over the counter will remain with the health care provider. ALL Medication MUST be in original bottles with correct labeling (one type of medicine per bottle). ALL Prescription Medicine must be in original bottle with the child's name and the medication clearly labeled. This is especially an issue for Inhalers, Epipens, Hormones, and Accutane, we NEED the box with the prescription label on it! Please ensure directions are correct and clear, as dosages and times often are adjusted.
Please list ALL medicine it is expected the camper will be taking during camp*
Format: Medicine, dosage, route (if not by mouth) and times
Does your camper need an ADA accessible cabin?*
Allergies

Please list any allergies and their severity in the relevant section(s) below.
DIETARY Allergies
MEDICINAL Allergies
ENVIRONMENTAL Allergies
Does your camper use an EpiPen?
If relevant, please list the allergy/situation that would trigger EpiPen use.
Is there anything else you would like us to know about your camper's allergies?
Authorizations
I hereby give permission for the designated Health Supervisor to provide routine medical care for my child for such minor injuries as scrapes and bruises and to dispense over-the-counter medications including but not limited to Tylenol, Advil/ Ibuprofen, cough drops, Neosporin, allergy medication, band-aids, etc., as prescribed or indicated by presenting symptoms. (There is room for comments at the end of this section)*
I grant my permission for routine medical care.
I hereby give my permission to Rocky Mountain Conference, La Foret staff (if applicable) and program staff to call a doctor or emergency medical service and for the doctor, hospital, or medical service to provide emergency medical or surgical treatment for my child should an emergency arise. It is understood that La Foret and program staff will make a conscientious effort to locate the emergency contacts listed before any action is taken. If such contacts cannot be made, I authorize La Foret and program staff to administer care they deem necessary. I hereby accept full financial responsibility for the payment of all expenses related to such emergency medical treatment.*
I grant my permission for emergency medical treatment.
In light of the Health Insurance Portability and Accountability Act (HIPAA) laws in Colorado, I hereby give my permission to an emergency medical facility treating my child to release information to La Foret or Rocky Mountain Conference Staff on behalf of my child in the event I cannot be reached, cannot be present, or am en route to the facility. This authorization is ONLY valid for the dates that my child is attending camp at La Foret.*
I authorize the release of my camper's medical information in the event of an emergency.
If there is a plan to move offsite during the program, you will know about it ahead of time. In some instances, a camper may need to leave the La Foret premises for emergency reasons, minor medical reasons, programmatic reasons, or safety (including evacuation- evacuation rendezvous point is 8701 Wolf Valley Dr. and is in the parent handbook that will be sent to you). In these instances, I hereby give my permission for my child to leave the La Foret premises whether on foot or by vehicle if RMC / La Foret staff deem it necessary.*
I grant my permission for moving offsite when necessary.
I give permission for this camper to receive COVID testing as needed or required during camp. This may be performed at the camp health office, at an outside health facility, or by the county or state health department as required and/or permitted by the current laws regulating testing. There will be no cost for this testing.*

I grant my permission for COVID testing.I will pick up my camper right away if they have COVID symptoms
Is there anything else about the camper's health you'd like us to know? Any additional comments?
Parent/Guardian Name*

First NameLast Name
Signature*

Clear
Today's Date*

MonthDayYear
Date
Hour MinutesAM/PM Option

Camper Health History

Please specify any relevant information in each of the following categories. Write "N/A" in any section that does not apply to your camper's health history.
Injuries*
Type "NA" if not applicable
Chronic Illnesses*
Type "NA" if not applicable
Communicable Diseases*
Type "NA" if not applicable
Drug Reactions and/or Drug Allergies*
Type "NA" if not applicable
Necessary Health Procedures*
These are procedures that would need to occur during camp. Type "NA" if not applicable

Dietary Requests

Please note we cannot accommodate PREFERENCES. Additionally, if the camper is signed up in a category below they will be expected to conform to this choice for the FULL event. Conversely, if the camper does not sign up for a category below, they cannot switch mid way. This is because we order all food ahead of time. People with dietary restrictions will be expected to self-identify to the kitchen staff. If registering a child, please coach your child accordingly.
Please specify if your camper has any dietary REQUIREMENTS.

VeganVegetarianGluten Free (Note: some gluten cross-contamination is possible)Dairy Free
Does your camper have a nut allergy?*
If so, what kind of nuts is your camper allergic to?
If relevant, is your camper's nut allergy airborne?
Please note any other special dietary needs or additional allergies.
If your camper has an extremely restricted diet, you may chose to provide food for them instead. If so, La Foret can store food and work with you to negotiate a decreased registration fee that does not include full food costs.

Roommate Request - Youth Event

If you know another youth registering for this event with whom your camper would like to share a room, please enter their full name here. We will take all requests into consideration and honor as many roommate requests as possible while maintaining the needs of the whole group. Roommate requests are not guaranteed.
Name of the person your camper would like to share a room with:
If no specific request, you may list qualities to help us match your camper.
For instance: night owl, early riser, light sleeper, introvert, tidy, etc.

Assumption of Risks

We are unable to accept your registration if you do not agree to the terms outlined on this Assumption of Risks page. Please contact La Foret's Director of Transformational Programming directly (719-822-7243 or logan@laforet.org) if you require further clarification. Thank you.
In consideration of my own or my child's participation in camping activities sponsored by the Rocky Mountain Conference, United Church of Christ, and/or held at La Foret or some other agreed upon location:

I understand that there are numerous risks associated with participation in any camping activities, including such risks as hiking, swimming, backpacking, out-camping, wildlife interactions, ropes courses, field games, crafts, and transportation to and from camp activities, and that many, but not all, of these risks are inherent in these and other activities. These risks, which contribute to the unique character and desirability of the activities involved, may pose the possibility of severe injury, illness, or death. I further understand that most of the activities involved in the camping experience at La Foret will take place in an outdoor environment, and that the Rocky Mountain Conference and La Foret staff have taken all reasonable measures to insure the safety and well being of all participants, including, but not limited to:
- Ensuring that any instructors for activities offered at La Foret meet all the regulatory requirements (local, state, federal) for that position or activity.
- Ensuring that all volunteers have been recommended by and approved by their local church and have participated in regularly scheduled RMC staff training events.
- Ensuring that all obvious and known hazards have been removed from the actual camping area and frequented grounds.
- Ensuring that all persons driving participants to and from activities have a valid driver's license.
I also understand that many of the risks inherent in the camping experience cannot be eliminated, altered or controlled. Some, but not all, of the specific risks include:
- Weather conditions may change rapidly and unpredictably and may directly cause injury. Severe weather such as thunderstorms, hail storms, lightning strikes, burning sun, cold temperatures, forest fires, tornadoes, and others may also affect camper safety through the secondary impact of power outages, impaired equipment, and structural damage.
- Equipment used in activities may break, fail or malfunction, despite reasonable maintenance and use, and may inflict injuries, even when used as intended. Persons using equipment may lose control of such equipment and cause injury to themselves and/or others.
- Most activities take place in a natural environment where unexpected, unseen, unknown, and/or unmarked objects and conditions create risk of injury, i.e. tripping, falling, slipping, insect bites, animal contact, unstable surface conditions, falling rocks and objects, potentially harmful vegetation, etc.
Counselors and guides use their best judgment in determining camper's ability to participate in camp activities. However, campers may have unknown conditions which would limit their participation in certain activities or increase camper's risk of injury. It is imperative that parents notify the event staff, in writing via this registration process, of any known limitations.

Motor and vehicle accidents, not the direct fault of directors, counselors, and La Foret staff, may occur in the course of transporting participants to and from other activities.

Some camping activities may have inherent risks, due to the nature of the camping experience, and there may be other risks which cannot be anticipated.

I acknowledge and assume all risks involved in participation in any of these activities and for any damage, illness, injury, or death resulting from such risks, for myself and my child. There are no physical, emotional, or mental problems or limitations associated with mine or my child's participation in camp activities, except as disclosed by me in writing on the medical and behavior pages of this registration.
*

Yes, I am acknowledge that I have read, understand, and abide by the statement above.
Name*

First NameLast Name
Signature*

Clear
Today's Date*

MonthDayYear
Date
Hour MinutesAM/PM Option

Release of Liability

We are unable to accept your registration if you do not agree to the terms outlined on this Release of Liability page. Please contact La Foret's Director of Transformational Programming directly (719-822-7243 or logan@laforet.org) if you require further clarification. Thank you.
I, on behalf of myself and/or my child, do understand and accept the risks of participation and do hereby release and waive any claim of liability against the Rocky Mountain Conference, United Church of Christ and the La Foret Conference and Retreat Center and its employees and agents with respect to any injury, illness, damage or death, occurring to me or my child while participating in any and all Outdoor Ministry camp/retreat programs and activities.

I agree that this form, and all other aspects of my relationship and my child's relationship with the Rocky Mountain Conference UCC and its agents and employees, including La Foret Conference and Retreat Center, shall be governed by the laws of the State of Colorado. Further, I agree that any legal proceedings concerning such relationship shall be filed exclusively in the State of Colorado.
Name*

First NameLast Name
Signature*

Clear
Today's Date*

MonthDayYear
Date
Hour MinutesAM/PM Option

Photo/Video Release Form
I understand that photographs may be taken of myself or my child during events sponsored in whole or in part by the Rocky Mountain Conference United Church of Christ and/or La Foret Conference and Retreat Center. I understand that some of these photos may be reproduced and/or used in printed materials, promotional materials, and on websites that are the property of the Rocky Mountain Conference, the La Foret Conference and Retreat Center, or other agents of the Rocky Mountain Conference. I am aware that photos of minors never include any identifying information about those pictured. I understand that any photos or video taken during RMC and La Foret events will never be sold or used for profit. I am aware that I will receive no compensation for the use of these photos.

I have read and understand the RMC Photo/Video Release policy. I grant permission to the RMC-UCC and the La Foret Conference and Retreat Center to use photographs and video footage of myself /my child in various RMC-UCC promotional projects.
Grant or Deny Permission*
Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date
Hour MinutesAM/PM Option

Terms and Conditions
Important Information- Please Read Carefully

A note about pricing: La Foret is a 501(c)3 nonprofit. We set pricing in order to be able to cover the cost of our quality programming, not to make a profit. The "Subsidized Level" ($150) is for those who regularly experience financial hardship. The "Sustainer Level" ($200) reflects the true cost of hosting one camper for a week at La Foret, based on estimates of attendance, supplies, food, etc. The "Supporter Level" ($250) is closer to what comparable programs in the area cost, and it allows us to offer the other tiers. However, we know that not every camper will be able to attend for that price. Thank you for selecting the level that most accurately represents your household's financial situation. We rely on the honor system to make tiered pricing possible.

Camperships Available: Our philosophy is that we never want money to be the reason a child does not come to camp. Please be aware that many churches in the Rocky Mountain Conference generously support campers. If you attend an RMC church, please inquire directly with your church leadership to access these funds. In past years, we used coupon codes. Moving forward, churches will provide campership funds directly to families, and then families will submit their payment. If additional funds are needed to make it possible for your child/youth to attend camp, please select "deposit only" and email logan@laforet.org to let us know how much addition funding you require or if you would like your fee broken into two payments. We have a campership fund and are happy to work with you to make it possible for your camper to come to La Foret.

Pay Later: If you need additional time to complete the payment, please select "deposit only" below and email logan@laforet.org to let us know what level you will be paying so we can send you an invoice for the remainder. Please note that registration is not confirmed until payment is made, and payment must be received 14 days prior to the start of camp.

Fees and Cancellations: To maintain the vitality of the outdoor ministry program, these are the requirements pertaining to fees and cancellations. Registrations fees are due two weeks prior to the start of the event. If the full balance is not received two weeks prior to the event, the camper's spot may be given to another. If you need to cancel your registration, you may do so up to 30 days before the event. Between 30 and 14 days before the event, we can refund all but $50 of the total cost. Within the final two weeks leading up to the event, we are unable to refund fees and will bill unpaid accounts accordingly. Thank you for your understanding and good stewardship of La Foret and Conference resources.
Name*

First NameLast Name
I have read and understand the above terms and conditions. *

Clear
Signature Date*

MonthDayYear
Date
Hour MinutesAM/PM Option

Check Out*

Fall Supporter Level

$250.00

Fall Sustainer Level

$200.00

Fall Subsidized Level

$150.00

Fall Deposit

$50.00

Enter coupon

Total

$0.00

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Fall Youth Retreat 2023 Camper Registration

Camper Information

Camper Profile

Camper History

Restrictions and Exclusions

Overnight Considerations

Social Abilities

Additional Comments

Pickup Authorizations and Emergency Contacts

Pickup Authorization

Emergency Contact #1

Emergency Contact #2

Household Form

Parent/Guardian Demographics

Medical Information and Authorizations

Allergies

Authorizations

Camper Health History

Dietary Requests

Roommate Request - Youth Event

Assumption of Risks

Release of Liability

Photo/Video Release Form

Terms and Conditions

Credit Card