TEEN REACH ADVENTURE CAMP 2025 - Camper Application// CAMPAMENTO DE AVENTURA TEEN REACH 2025 - Solicitud de Campista

SECTION 1. Camper Information
SECCIÓN 1. Información del campista

Angel Tree

We are so excited to continue partnering with Angel Tree, an organization serving children whose biological parents are or have been incarcerated. Please complete the following information so we know if your camper is eligible for additional resources from Angel Tree. At the end of camp, if you give us your permission, we will share the camper's name, your contact info, and the info below with Angel Tree so they can contact eligible campers.

Estamos muy emocionados de continuar asociándonos con Angel Tree, una organización que atiende a niños cuyos padres biológicos están o han estado encarcelados. Complete la siguiente información para que sepamos si su campista es elegible para recibir recursos adicionales de Angel Tree. Al final del campamento, si nos da su permiso, compartiremos el nombre del campista, su información de contacto y la información a continuación con Angel Tree para que puedan comunicarse con los campistas elegibles.

SECTION 2. Camper Personal Details

Please help us get to know the Camper better so we can provide positive interactions and activities at camp.

SECCIÓN 2. Datos personales del campista

Por favor, ayúdanos a conocer mejor al campista para que podamos ofrecerle interacciones y actividades positivas en el campamento.

SECTION 3. Emotional & Behavioral History

Indicate below the degree to which the teen has displayed the following emotions/behaviors in the past 12 months. Please answer honestly. (Note: Negative behaviors do not disqualify a Camper from attending camp. We ask for behavior history so that we are equipped to give your youth the best Camp experience possible.)

SECCIÓN 3. Historial emocional y conductual

Indique a continuación el grado en que el adolescente ha mostrado las siguientes emociones/comportamientos en los últimos 12 meses. Por favor, responda honestamente. (Nota: Los comportamientos negativos no descalifican al Campista para asistir al campamento. Nada más preguntamos para que seamos más equipados a dar la mejor experiencia a su campista).

SECTION 4. Medical Information
SECCIÓN 4. Información médica

Camper Medications / Medicamentos para los campistas

Please list ALL medications the Camper is taking.

NOTE: MEDICATIONS MUST BE IN ORIGINAL PRESCRIPTION BOTTLES FROM PRESCRIBING PHYSICIAN. THIS IS NOT THE TIME TO GIVE MEDICATION A VACATION.

If applicable, you MUST bring the camper's Epipen, albuterol inhaler, and any other medications they may need to camp check-in, even if they are only used "as needed."

Por favor, anote TODOS los medicamentos que el campista está tomando.

NOTA: LOS MEDICAMENTOS DEBEN ESTAR EN LOS FRASCOS ORIGINALES DEL MÉDICO QUE LOS RECETÓ. ESTE NO ES EL MOMENTO DE DAR VACACIONES A LOS MEDICAMENTOS.
Si corresponde, usted DEBE traer el Epipen (inyección de epinefrina), el inhalador de albuterol, o cualquier otro medicamento para el campista que pueda necesitar al Check-In del Campamento (registro), incluso si solo se usan "cuando es necesario."

SECTION 5. Permission to Administer First Aid & Over-the-Counter Medications

I hereby give the Teen Reach Adventure Camp Medical Staff permission to administer first aid and the following products according to manufacturers' instructions, or as otherwise specified.

I trust the T.R.A.C. Medical Staff to use his/her best judgment as situations arise, and if in doubt, he/she can call.

SECCIÓN 5. Permiso para administrar primeros auxilios y medicamentos de venta libre

Por la presente doy permiso al personal médico del campamento de aventura Teen Reach para que administre los primeros auxilios y los siguientes productos de acuerdo con las instrucciones de los fabricantes, o según se especifique.

Confío en que el personal médico del T.R.A.C. utilizará su mejor criterio según las situaciones que se presenten, y en caso de duda, puede llamar.

SECTION 6. Medical & Liability Release (English)
MEDICAL RELEASE: This health history is correct so far as I know, and the above-named minor has permission to engage in all prescribed program activities. The undersigned does hereby authorize T.R.A.C., on behalf of the undersigned, to consent to an X-ray examination, anesthetic, medical, dental, or surgical diagnosis or treatment and hospital care for the above minor, which is deemed advisable by, and to be rendered under the general or special supervision of any physician/surgeon, licensed under the provision of the Medical Practice Act or any dentist licensed under the Dental Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, at camp or elsewhere. This authorization will remain effective while the above minor is en route to and from or involved in or participating in any camp program, unless revoked in writing by the undersigned and delivered to the Camp Director. During camp, prescription medication will be administered to youth as directed by a physician. T.R.A.C. will do everything in its power to prevent incorrect medication from being given. However, the local T.R.A.C./Teen Reach/DBA T.R.A.C./Teen Reach Adventure Camp and King's Harbor Church South Bay, is not liable for incorrect medication provided to us by the legal guardian, incorrect dosages given, nor is it liable for wrong labeling on medicine bottles. Legal guardians are responsible for checking in the correct medication, bottles and dosages at the time of registration. This is not the time to give medication vacations to your teen.

LIABILITY RELEASE: Every precaution will be taken to protect campers and volunteers from harm, but the local T.R.A.C./Teen Reach/DBA T.R.A.C./Teen Reach Adventure Camp is not liable for injuries/death that youth or volunteer staff may incur while camping or participating in T.R.A.C. activities. If he/she is injured, I have given medical information and permission to take him/her to a medical facility for proper care. All extension activities are included in the liability release. I release the local T.R.A.C./Teen Reach/DBA T.R.A.C./Teen Reach Adventure Camp and King's Harbor Church South Bay, from any liability surrounding any injuries/death to the camper and/or the camper's unborn child if the camper is pregnant.

As legal guardian of the above youth, I agree that all the information provided in this application is accurate. I also agree to both the medical and liability releases and the permission to administer first aid and over-the-counter medications as indicated in Section 5 above.

NOTE: AT CAMP REGISTRATION, MEDICATIONS MUST BE IN ORIGINAL PRESCRIPTION BOTTLES FROM PRESCRIBING PHYSICIAN. THIS IS NOT THE TIME TO GIVE MEDICATION A VACATION.

SECCIÓN 6. Exención de responsabilidadmédica y de responsabilidad civil (Español)

NOTE: I certify I am the legal guardian of the above applicant. To be legally binding, I must use a legally binding electronic signature service such as DocuSign OR print, sign in pen, & scan to return.

NOTA: Certifico que soy el tutor legal del solicitante arriba mencionado. Para que sea legalmente vinculante, debo utilizar un servicio de firma electrónica legalmente vinculante como DocuSign O imprimir, firmar con bolígrafo y escanear para devolverlo.

SECTION 7 - Teen Reach Adventure Camp - CONSENT FORM (English)

COUNSELORS/STAFF: Every effort will be made to contact the camper's camp counselor from Royal Family KIDS Camp so consistency may be achieved from camp-to-camp. However, this is not always possible. All camp counselors and staff at Teen Reach Adventure Camp are interviewed, screened with background checks/fingerprints, and receive training before volunteering on the T.R.A.C. Team.

CONFIDENTIALITY: Every youth registered at T.R.A.C. has the right to confidentiality. Our camp counselors are instructed not to take photos or exchange addresses, phone numbers, email addresses, or social media accounts with any camper. Any photographs or videos obtained by T.R.A.C. will be edited, by blocking out faces, before being used in any promotional materials.

SAFETY: Every precaution will be taken to protect campers and volunteers from harm.

LIABILITY: T.R.A.C. volunteers are aware of our responsibility to keep each youth safe but Teen Reach/Teen Reach Adventure Camp/T.R.A.C. is not liable for injuries/death youth or volunteer staff may incur while at camp or participating in T.R.A.C. activities.

MEDICATION: Each day of T.R.A.C., medication will be administered to youth as directed by their physician. Teen Reach Adventure Camp will do everything in its power to prevent incorrect administration of medications. However, T.R.A.C./Teen Reach is not liable for incorrect medication provided by the legal guardian, incorrect dosages given, nor is it liable for wrong labeling on medicine bottles. Legal guardians are responsible for providing the correct medication, bottles and dosages at the time of check-in. THIS IS NOT THE TIME TO GIVE MEDICATION VACATIONS to your youth.

FINANCIAL COMMITMENT: T.R.A.C. is made possible by the volunteer hours and donations committed to running this program. T.R.A.C. is free for the caregivers and campers attending.

PARTICIPATION AGREEMENT: At T.R.A.C., campers and volunteers will participate in activities such as high ropes course, boating, kayaking, swimming, and archery, among other activities.

I acknowledge that participation in Teen Reach Adventure Camp and the activities described above involves risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage, and financial damage.
In consideration for the opportunity to participate in the activity described above (the “activity”), the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to as the “activity sponsor”). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise.
If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association.

SECCIÓN 7. Teen Reach Adventure Camp - Selecione la flecha del lado derecho (Español)