Camp True North Registration Form

Event Registration

FOR ADDITIONAL QUESTIONS OR CONCERNS ABOUT THE EVENT OR REGISTRATION CONTACT THE SISTERCARE CAMP TRUE NORTH COORDINATOR AT VOLUNTEER@SISTERCARE.COM
Registrant's Information
Child's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Grade*
School*
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
Parent/Guardian Information
Name*

First NameLast Name
Home Number*
Cell Number*
E-mail*
example@example.com
I authorize the following individual to pick up my child:*

First NameLast Name
Authorized individual's phone number: *
Please enter a valid phone number.
What are you hopeful your child will gain from attending Camp True North*
How did you hear about Camp True North? *
MINOR PARTICIPANT HOLD HARMLESS AND RELEASE AGREEMENT
Event: Teen Outreach Event at Camp Cole
Date: May 3, 2025

I, the undersigned parent or legal guardian of the minor participant named below, acknowledge and agree that my child is voluntarily participating in the Teen Outreach Event at Camp Cole, sponsored by Sistercare. In consideration for my child's participation, I agree to the following terms:

1. I understand the nature of the event, which includes indoor programming (discussions on healthy relationships, red flags, etc.) and outdoor recreational activities, and accept all associated risks.

2. I voluntarily release and hold harmless Sistercare, its staff, board members, volunteers, and affiliates from any and all claims, liabilities, or injuries arising from my child’s participation.

3. I assume full responsibility for any risk of injury, loss, or damage incurred by my child during the event.

4. This release is binding upon me, my child, and our respective heirs, assigns, and legal representatives.
Minor's Name*

First NameLast Name
Printed Name of Parent/ Guardian:*

First NameLast Name
Signature*

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Date*

MonthDayYear
Hour MinutesAM/PM Option
MINOR MEDICAL RELEASE FORM
Event: Teen Outreach Event at amp Cole
Date: May 3, 2025

I, the undersigned parent or legal guardian of the minor participant named below, hereby grant permission for Sistercare and its representatives to use photographs, video, or written materials in which my child may appear for informational or promotional purposes.

1. I understand that participation in media is voluntary and my child may use an alias or opt out entirely.

2. I authorize the use of my child’s likeness and/or voice in media formats related to this event.

3. I understand that no last names or sensitive identifying information will be disclosed.

4. I release Sistercare from any claims related to the use of such media.
Minor's Name*

First NameLast Name
Printed Name of Parent/Gaurdian*

First NameLast Name
Signature*

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Date*

MonthDayYear
Hour MinutesAM/PM Option
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.
Date*

MonthDayYear
Signature*

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EMERGENCY CONTACT AND MEDICAL AUTHORIZATION FORM
Event: Teen Outreach Event at Camp Cole
Date: May 3, 2025
Child's Name*

First NameLast Name
DOB*

MonthDayYear
Date
Parent/ Guardian Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Alternate Emergency Contact*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Medical Conditions or Allergies:*
Medications: *
Health Insurance Provider*
Policy #*
I authorize Sistercare staff and volunteers to seek emergency medical treatment for my child if I or the emergency contact cannot be reached. I understand that all reasonable efforts will be made to contact me before such action is taken.
Name*

First NameLast Name
Date*

MonthDayYear
Hour MinutesAM/PM Option
Signature*

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CAMP COLE WAIVER

Camper’s Name: _{childsName}_____________________________

This agreement must be read and signed for you/your child to be eligible to attend Partner Camp at Camp Cole.

I.             PARTICIPATION CONSENT

I understand and certify that my/my child’s participation in partner camp, Inc. and its activities at Camp Cole is completely voluntary.   I have familiarized myself with the partner camp, Inc. program and activities at Camp Cole in which I/my child will be participating. I recognize that certain hazards and dangers are inherent in these activities, which may include, but not limited to, the activities of horseback riding, high and low elements ropes course, swimming, archery, gardening, cooking, biking, sports, lake swimming, and boating. I acknowledge that although partner camp, Inc. and Camp Cole have taken safety measures to minimize the risk of injury to camp participants, partner camp, Inc. and Camp Cole cannot insure or guarantee that the participants, equipment, premises or activities will be free of hazards, accidents or injuries. I recognize and have instructed my child in the importance of knowing and abiding by the rules, regulations, and procedures for partner camp, Inc. at Camp Cole. Further, I attest that my health insurance will cover any medical and hospital expenses that I/my child incur and I have received approval from a doctor authorizing me/my child to participate in the partner camp, Inc. activities at Camp Cole. I also agree to inform partner camp, Inc. of any activities in which I/my child may not participate. I understand and agree that my child will be in an environment that involves elements related to nature, camping or community living, such as insects and insect bites, sun exposure, or communicable illnesses.

II.             LIABILITY RELEASE

I, the undersigned, understand that occasionally accidents occur during camp activities and that participants may sustain serious personal injury and property damages as a consequence thereof. Knowing the risks of camp activities, nevertheless, I agree to assume those risks and by signing this liability release, I intend to legally bind myself, my minor children, my heirs, executors, and administrators. I hereby release and forever discharge partner camp, Inc. and Camp Cole, and any of their officers, directors, employees, partners, shareholders, board members, servants, agents and assigns from and against all claims, causes of action, damages, losses and/or expenses arising out of or relating to any injury, illness, or loss of any kind, known or unknown, including but not limited to injuries to property or person, to me/my child during or related to my/my child’s attendance at partner camp, Inc. at Camp Cole.
III. MEDIA RELEASE

I do ____I do not ___ give partner camp, Inc. and Camp Cole the right to interview and/or to take photographs, audio or audio-visual recordings of me/my child to be used in promotional, educational or fundraising materials including, but not limited to videotapes, pamphlets and brochures. I understand my/my child’s name may be used in connection with these materials. By signing this media release, I intend to legally bind myself, my minor children, my heirs, executors and administrators. partner camp, Inc. and Camp Cole shall have the right to use photographs or other images of me/my child in promotion, educational or fund-raising materials. I acknowledge that partner camp, Inc. or Camp Cole shall have all rights of copyright in and to such photographs and videotapes and may use such copyright fully. I also hereby release partner camp, Inc. and Camp Cole and its officers, agents and employees from all liability connected with the taking and use of these materials as is authorized by partner camp, Inc. and Camp Cole. In addition, I waive all rights, interest or claims for payment in connection with any exhibition or release of these materials. This consent is voluntary, and I give it in the interest of public information, education, the furtherance of the goals of these institutions, or other lawful purposes. I acknowledge that I have legal authority to sign this form on behalf of the minor whose name is mentioned above.
Media Release Permission*
IV. PROGRAM AND OUTCOMES EVALUATION

I do__ I do not__ give partner camp, Inc. and Camp Cole to survey me/my child in confidential and voluntary program evaluation at Camp Cole. I understand that my/my child’s name will not be used in conjunction with surveys and the data collected will be used to improve programming at Camp Cole and other camps and programs.
Program and Outcomes Evaluation Permission*
V. DISPUTES

I agree that any dispute concerning, relating to, arising out of or referring to the subject matter of this contract shall be resolved exclusively by binding arbitration in Columbia, South Carolina. The arbitration shall be administered by JAMS and conducted before a single arbitrator in accordance with the JAMS Rules. The arbitrator shall have exclusive authority to resolve any dispute relating to the interpretation, applicability, enforceability, conscionability, or formation of this contract, including but not limited to any claim that all or any part of this contract is void or violable.
Parent/Guardian/Self Signature*

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Date*

MonthDayYear
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Event Registration

Registrant's Information