Squeaky Boots Summer Camp 2023

Summer Camp 2023

Squeaky Boots LLC
Parent/Guardian (Primary person of contact)

First NameLast Name
Parent/Guardian Email
example@example.com
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary person of contact:

First NameLast Name
Secondary phone number:
Please enter a valid phone number.Format: (000) 000-0000.
PARENT/GUARDIAN: What are some things you are hoping your child will experience and learn from this camp? (For example: new backpacking skills, social skills, build community, a place for them to disconnect from media, etc...)
Child/Camper

First NameLast Name
Preferred pronouns (For example: she/her, he/him, they/them, she/them, he/them, etc...)
Birthday* *
Please list any medical and/or dietary needs and/or allergies your camper has. Type N/A if none.
CAMPER: What are you hoping to experience and learn from this camp? (For example: backpacking skills, meeting new friends, learning how to regulate my emotions, connecting to nature, you just really like hiking, etc...)
Select the camp week you would like to register for.
PHOTO/VIDEO/STATEMENT RELEASE FORM: I grant permission to Squeaky Boots LLC and its employees the irrevocable and unrestricted right to produce photographs and video taken of my child while at Squeaky Boots LLC's Hiking Camp for any lawful purpose including publication, promotion, illustration, advertising, trade, or historical archive in any manner or in any medium. I hereby release Squeaky Boots LLC and its legal representatives from the liability for any violation or claims relating to said images or videos. Furthermore, I grant permission to use the statements of my child given during an interview with or without the name for the purpose of advertising and publicity without restriction to time limit or geographic area. I waive my right or my child’s right to any and all compensation stemming from the use of these materials.
PHOTO/VIDEO/STATEMENT RELEASE SIGNATURE (if marked "no" please leave this section blank)
I have read and agree with Squeaky Boots LLC's Liability Waiver and Child Abuse Protocols.
Where did you hear about the summer camp program?

Other
Interested in a payment plan?

Send us an email at squeakybootsllc@gmail.com to enquire about our payment options.

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Summer Camp 2023

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$300.00

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Summer Camp 2023

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