• 2025 BTS Summer Camp Registration

    2025 BTS Summer Camp Registration

    Week 1 June 9 - 13
  • THIS CAMP IS FULL 

    Blue Tailed Skinks Summer Camp week 1 registration is open to the following ages/groups:


    – Pedal Bikes recently completed grades k - 2

    This form needs to be filled out separately for each child. 

    Camp registration fees are:

    – $495 per athlete (10% discount applies for 2 kids from same family, 15% discount applies for 3+ kids from the same family, use 2SKINKS or 3SKINKS for each registration)

    Registration includes:

    – 1 week of camp M-F from 9:00AM - 3:00PM (with free early drop off starting at 8:30AM)
    – A Skinks Summer Camp Teeshirt
    – Ride Snacks
    – Discount at Participating Bike Shops (Such as the Bike Peddler in Santa Rosa)

     

    BTS is a 501(c)(3) nonprofit run by volunteers. All funds go back to the program.

    Please let us know if you have any questions at all. Thank you!

    The BTS Board of Directors

    Matt Fritzinger
    Chairperson

    Jeremiah Price
    Secretary

    Miko Lim
    CFO

    Larissa Connors
    Boardmember

    Caitlin Reinman
    Boardmember

    Mark Vandewalle
    Boardmember

  • Child Athlete Information

  • Parent/Guardian Information

  • Parent/Guardian 2 Information

  • Emergency Contact Information

    PLEASE DO NOT LIST PARENTS. We will contact parents first in the event of an emergency.

  • Authorized Pick Up

    The following people have my complete permission to pick up my child(ren) at anytime, from Skinks Camp. (PLEASE DO NOT LIST PARENTS OR EMERGENCY CONTACT). *

  • Misc Information

    Please feel free to list anything here that may help us get to know your camper better.  
  • Photo and Media Authorization and Agreement

  • By clicking "I Agree" below, I hereby grant permission to Blue-Tailed Skinks to use photographs and/or videos taken of me (or my child, if applicable), including but not limited to:

    Advertising or promotional materials
    Social media platforms
    Websites
    Print publications
    Exhibitions or public displays

    I understand that:

    These photographs/videos may be edited, published, distributed, or displayed at the discretion of Blue-Tailed Skinks.
    I will not receive any compensation, royalties, or other payments for the use of these photographs/videos.
    This release is irrevocable, worldwide, and perpetual in nature.


    Waiver and Release of Liability

    I release and discharge Blue-Tailed Skinks, its agents, representatives, and assigns from any claims, demands, or causes of action that I may have related to the use of the photographs/videos.

    Consent for Minors (If Applicable)

    If the subject is under 18 years of age, I, as the parent or legal guardian, grant permission for the use of the photographs/videos of my child, as outlined above.

  • Waiver of Liability, Assumption of Risk and Indemnity Agreement

    My Knowledge of the Risks of Mountain Biking: Mountain biking is action sport that offers participants exercise, and an opportunity to develop skill, strength, and endurance, and to test one’s abilities. The organizers of the Blue Tailed Skinks endeavor to provide a place for mountain bike riding but want you to understand that while some of the unwanted risks of mountain biking can be eliminated, the very nature of mountain biking makes it impossible to eliminate all of the risks involved – thus injuries can and do result from such risks of participation. You acknowledge these risks and that there are natural, manmade, mechanical and environmental conditions and risks that independently or in combination can result in participants to sustain injury.

    Medical Release and Authorization. As Parent and/or Guardian of the above named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

    Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

    Permission is also granted to the Blue Tailed Skinks and its affiliates including directors, coaches, volunteers and team parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

    This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the minor child, in my absence.

    Waiver: In return for being permitted to participate in Blue Tailed Skinks, including my child or children participating in trail rides, practices or any event related to the club, I, for myself, my heirs, my child or children, personal representatives and assigns, do hereby release, waive, discharge, and promise not to sue the Blue Tailed Skinks, its directors, officers, organizers, employees, volunteers, and agents (“The Club") from liability from any and all claims, including the negligence of The Club, resulting in personal injury (including death), accidents or illnesses, and property loss, in connection with my participation in the Blue Tailed Skinks.

    Assumption of Risks: Participation in the Blue Tailed Skinks carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injury. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains; to 2) major injuries such as eye injury, joint or bone injuries, and concussions; to 3) catastrophic injuries.

    Indemnification and Hold Harmless: I also agree to indemnify and hold The Club harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees arising out of my or my child or children's involvement in Blue Tailed Skinks, and to reimburse them for any such expenses incurred.

    Severability: I further agree that this Waiver of Liability, Assumption of Risk and Indemnity Agreement is intended to be as broad and inclusive as permitted by law, and that if any portion thereof is held invalid, the remaining portions will continue to have full legal force and effect.

    Governing Law and Jurisdiction: This Agreement shall be governed by the laws of the State of California, and any disputes arising out of or in connection with this Agreement shall be under the exclusive jurisdiction of the courts of the State of California.

    Acknowledgment of Understanding: I have read this Waiver of Liability, Assumption of Risk, and Indemnity Agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue on behalf of myself or my child or children. I confirm that I am signing the agreement freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

  • Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC 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.

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