2024 WWR Camper Health Form

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Wildwood Ranch 2024 Online Health Form

- 2024 Camper Health Information & Agreements -

To begin the online registration, click the Next button below.

If you need more information on Summer Camp 2024, email
us info@wildwoodranch.org, call us at 855-550-2267, or click HERE
for more information on our Summer Camp Programs.

General information
Campers Name*

First NameLast Name
Gender*

MaleFemale
Birth Date*

MonthDayYear
Home Phone*
Cell Phone
Work Phone
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
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Signatures and Agreements
I understand that there will be physical activities of which my child may participate and that my child may be exposed to the possibility of injury. I hereby expressly waive any and all liabilities on the part of Detroit Rescue Mission Ministries (DRMM) and their staff for any such injury. I give permission for routine medical treatment to be administered to my child. In case of an emergency, and I cannot be contacted, I give permission for DRMM staff to select a licensed physician and authorize the physician to secure proper treatment for my child. I understand that I am financially responsible for all health care related expenses for my child. I understand that photographs and / or videos may be taken of my child while at camp. Parent/guardian of the participating child hereby grants DRMM, American Camp Association, Christian Camp and Conference Association and Prison Fellowship Ministries (“PFM”) and their affiliates and agents, irrevocable permission to use, record, and reproduce the image and likeness of his/her participating child in any manner and in all media now or hereafter known, for any and all purposes (including advertising and promotional use), in perpetuity throughout the world, without restriction as to alteration. Parent/guardian and participating child give this consent with no claim for payment. Ages of camps are inclusive. Older campers may NOT attend a younger camp. All camps are co-ed. Wildwood Ranch will not discriminate against any individual or group because of race, gender, religion, age, national origin, color, marital status, family status, handicap or political beliefs. When your application and deposit are received, a medical form and confirmation letter will be sent to you explaining camp procedures, spending money and a suggested list of needed articles for your stay at Wildwood Ranch.*

I agree
Please sign here:*

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