DAAPcamps REQUIRED RESIDENTIAL CAMP FORMS

DAAPcamps Residential High School Camper Forms
In the section below, please select the camp for which you have registered this camper for this summer. Remember, they must be registered in a camp BEFORE completing the following required waiver acknowledgements. Thank you!
High School Architecture/Interior Design Camp (entering grades 10, 11, 12)High School Communication Design Camp (entering grades 10, 11, 12)High School Fine Art Studio Camp (entering grades 10, 11, 12)High School Fashion Design Camp (entering grades 10, 11, 12)High School Industrial Design Camp (entering grades 10, 11, 12)High School Footwear Design Camp (entering grades 10, 11, 12)
Camper Information
Camper Preferred Name*

First NameLast Name
Camper Cell Phone Number*

Area CodePhone Number
Parent/Guardian 1 Name*

First NameLast Name
Parent or Guardian 1 Cell Phone Number*

Area CodePhone Number
Parent or Guardian 1 Email
example@example.com
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Cell Phone Number

Area CodePhone Number
Emergency Contact Name (The person we contact in case a parent/guardian is unavailable.)*

First NameLast Name
Emergency Contact Phone Numer*

Area CodePhone Number
Relationship to Camper
Medication and Medical Conditions and/or Accessibility Accommodations
YesNo
If yes, please list ALL medications.
If your camper has prescription medications that will be administered while at camp, please download a copy of the Rx form which will need to be completed in part by a prescribing medical professional. The form will need to be filled out and brought with the camper (and their medication) when coming to camp.This form is kept with the camper's medication as verification for administration of noted prescriptions. The form can be downloaded here:

Camper Rx Form for DAAPcamps
YesNo
If yes, please list conditions and /or accessibility resources for which we should be aware.
Insurance and Health Care Providers
YesNo
Policy Holder Name

First NameLast Name
Insurance Carrier Name
ex. Anthem
Policy Group Number
Insurance Carrier Phone

Area CodePhone Number
Physician Name

First NameLast Name
Physician Phone

Area CodePhone Number
Dentist Name

First NameLast Name
Dentist Phone

Area CodePhone Number
Authorization for Medical Care
Authorization Required. Must be signed by parent/legal guardian

By acknowledging and signing below, I am delivering an electornic 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.

I hereby give DAAPcamps and its agents thereof permission to contact an emergency hospital, EMT, or physician to provide treatment to my child/ward, in the event that I cannot be reached during an emergency.
Please use cursor to write signature.*

Clear
Parent/Legal Guardian Signature*

First NameLast Name
Date of Signature Above

MonthDayYear
Date
Waiver Acknowledgements - Please open the link below to read the Residential Camper Comprehensive Waivers, then sign for acknowledgement in the Authorization section.
Please read the attached Residential Camper Comprehensive Waivers and sign below to indicate agreement.

DAAPcamps Residential High School Camp Comprehensive Waivers and Policies

Please refer to the above attached Waiver Document for the following:
- Photography and Marketing Release Statement
- General DAAPcamps Policy Statement
- UC Liability for Minors Statement
- UC Residence Hall Policies and Housing Agreement
Authorization Required. Must be signed by parent/legal guardian.

By acknowledging and signing below, I certify that I have read and agree to the statements and policies described therin. I also acknowledge that I am delivering an electornic 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.
Please use your cursor to write your signature. (Parent/legal guardian.)*

Clear
Parent/Legal Guardian Signature*

First NameLast Name
Date Signed

MonthDayYear
Date
Should be Empty:

DAAPcamps Residential High School Camper Forms

In the section below, please select the camp for which you have registered this camper for this summer. Remember, they must be registered in a camp BEFORE completing the following required waiver acknowledgements. Thank you!

Camper Information

Medication and Medical Conditions and/or Accessibility Accommodations

Insurance and Health Care Providers

Authorization for Medical Care

Waiver Acknowledgements - Please open the link below to read the Residential Camper Comprehensive Waivers, then sign for acknowledgement in the Authorization section.