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  • Camp Abilities NJ @ Rowan University Athlete Registration & Medical History Form

  • Camp Abilities NJ @ Rowan University
    Friday, June 26- Sunday, June 28
    Rowan University
    Glassboro, NJ

    Complete this form to register for Camp Abilities NJ @ Rowan University's Summer Camp, which will occur from June 26-28, 2026 at Rowan University in Glassboro, NJ. Athletes and coaches will be housed at the university, and meals from dinner on Friday through lunch on Sunday are included in the program.

    Your athlete will also need a medical form signed by a doctor. You can download that form here or we can mail it to you. 

    Camp Abilities NJ @ Rowan University requires a $100 deposit per child to hold their spot, which will be returned when you arrive at camp. The check will not be cashed and the original check will be returned upon arrival. If this is a hardship for your family, please contact us about the availability of scholarship funds. Checks can be written out to Rowan University and mailed to Maria Lepore-Stevens, Rowan University James Hall 2046, 201 Mullica Hill Rd, Glassboro, NJ 08028.

    Camp Abilities NJ @ Rowan University is an educational sports camp for athletes ages 6-17 who have visual impairments. Children who present the following behaviors are not a match for Camp Abilities NJ: biting, kicking, scratching, hitting, self-injurious behavior, elopement, verbal or physical threats to self and/or others, or continuous noncompliance.

     

    We hope to see you at camp!

    The Camp Abilities NJ @ Rowan U Leadership Team

    Maria Lepore-Stevens, EdD, CAPE, COMS
    Shari Willis, PhD, WFR
    Directors, Camp Abilities NJ @ Rowan University

    Isis Bolden, Kayleigh Fryer, Taleen Hamad, David Liano,
    Logan Robenolt, and Kai Willis-Carrol
    Admin Staff, Camp Abilities NJ @ Rowan University

     

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  • Emergency Contact

    Please list an emergency contact if the parents/ guardians above are unavailable in an emergency situation.
  • Athlete Sport and Vision Information

    Camp Abilities NJ @ Rowan U is a sports camp for athletes who are visually impaired. Please provide us with more information about your athlete's vision and sport skills.
  • Health History

    Please check the conditions that are applicable to your athlete. Further describe any "yes" selections in the box below.
  • Medical Provider and Insurance Information

  • Assumption of Risk and Authorization For Emergency Medical Treatment

  • I hereby certify I am the parent or guardian of the above-named minor child (“minor child”) and agree that the minor child has my approval to participate in the Camp Abilities NJ @ Rowan University (“Activity”) at Rowan University, to be held June 26-28, 2026.

    I agree to allow the minor child to participate in the Activity and, on behalf of the minor child, our heirs, personal representatives or assigns, affirm that the minor child is voluntarily participating in the Activity, which may or may not include transportation by Rowan University.  I assume all risks of injury, illness, or loss of personal property resulting from the minor child’s participation in the Activity.  This Acknowledgment of Risk and Release includes, without limitation, all injuries which may occur as a result the minor child’s participation in the Activity.

    In full awareness of the above and in consideration of the minor child’s participation in the Activity, to the extent permitted by law and not inconsistent with the New Jersey Tort Claims Act, I do hereby waive, release and discharge any and all claims for death, illness, injury or damage (including the spread of infectious diseases) against Rowan University, and all affiliates, employees, officers, agents, representatives, successors, or assigns, relating to the Activity, which I may have as a result of my election to allow the minor child to participate in the Activity. I understand and agree that this waiver shall release Rowan University from any claims based on the actions or omissions of the University, its employees, officers, agents, representatives, successors or assigns, whether any infection, illness or harm occurs before, during, or after the minor child’s participation in the Activity. I further agree that this release and agreement not to sue will be binding on my heirs and successors.

    I further agree that if a claim is filed by a third party in connection with any of the minor child’s conduct or behavior while engaged in the Activity, I will indemnify and hold harmless Rowan University, its employees and representatives against any such claims, including attorneys’ fees incurred by Rowan University in defending such claims.

    I hereby consent to and authorize the use and reproduction by Rowan University and Camp Abilities NJ @ Rowan University, or anyone authorized by Rowan University, of any and all photographs, videography, and audio recordings that have been taken of the minor child during the Activity, without compensation to me, the minor child or assignees. If I do not consent to the above conditions with respect to photos, I will note it below my signature. 

    I also give permission for the minor child to receive any emergency medical treatment by healthcare professionals, including emergency medical transportation, which may be required for injuries sustained by the minor child.  I further agree to be responsible for any medical bill incurred as a result of any personal illness or injury to the minor child.  

    If any portion of this Release shall be deemed by a court of competent jurisdiction to be invalid, then the remainder of this Release shall remain in full force and effect and the offending provision or provisions will be severed herefrom. By signing this Release, I acknowledge that I understand its content and that this Release cannot be modified orally.

    I acknowledge that I have carefully read this document and fully understand that it is a release of liability. I affirm that I am 18 years of age and competent to sign this document on behalf of the minor child.

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