Camper Enrollment Form Logo
  • Summer camp banner image with children
  • Camper Enrollment

  • Camper Information

  • Parent/Guardian Information

  • Camp Session Choices

    I would like to enroll my child in the following:
  • Emergency Information

  • We are happy to administer prescribed medicines as needed. Please provide the medicines in their original packaging with instructions for our staff.

  • Informed Consent and Acknowledgement

    WILD ANIMAL and WILDERNESS INTERFACE
    Rising Hill Learning and the surrounding neighborhood, the Meadows of Altadena, is located within the boundaries of the Angeles National Forest. This provides us with stunning natural opportunities, including hyper-local access to trailheads, fresh canyon air and seasonal streams.

    o   I acknowledge that while in the Angeles National Forest, my child may encounter native creatures big and small, including but not limited to: spiders, bees, snakes, racoons, bobcats, coyotes, bears and mountain lions.

    o   I acknowledge that while in the Angeles National Forest, my child will be in a natural setting that includes and is not limited to: rough terrain, uneven ground, rocks, pokey and noxious plants, and other elements that may cause harm or injury.

    FARM ENVIRONMENT
    The yard hosting Rising Hill Learning has uneven paths and rustic structures. When visiting and participating in activities, children will interact with domestic animals, and farming and gardening tools and structures.

    o   I acknowledge that natural and garden settings provide myriad multisensory opportunities including but not limited to: uneven pathways, rocks, sticks, and thorny, pokey or noxious plants.

    o   I acknowledge that my child may incur minor injuries while participating, from rustic structures, enclosures, fences, and tools.

    o   I understand that when scared or hurt, an otherwise gentle animal may try to communicate with scratches, bites or kicks. I acknowledge that, although unlikely, my child may incur minor injuries while interacting with animals.

  • Medical Release and Authorization

    As Parent and/or Guardian of the named camper, 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 camper. 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 Rising Hill Learning and its affiliates to provide the needed emergency treatment prior to the child’s admission to the medical facility.

    Release authorized on the dates and/or duration of the registered season.

    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 named minor child, in my absence.

  • 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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  • Secure your enrollment!

    Within the next few days you will receive acknowledgement and a request for a deposit of $45. This amount will go towards the cost of camp, which is due on June 1. Should you choose to withdraw your child, we will be sad to not enjoy summer time with them, but the deposit is non-refundable.
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