Junior High Summer Camp 2025 Registration

Event Name: Junior High Boys Summer Camp 2025

For Grades Entering 6th-8th

Camp Location: 42050 Wilcox Rd. Hat Creek, CA 96040
Camp Date: July 31- August 3, 2025

After registration is completed and as camp dates approach, an email including frequently asked questions, a list of what to bring or not bring, and more information will be sent to the email address listed on this registration form.

Camper's Name*

First NameLast Name

Age*

Grade Entering (next school year)*

Date of Birth*

Parent/Legal Guardian Name*

First NameLast Name

Relationship to the Camper*

Phone Number 1*

Phone Number 2

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Name of Emergency Contact (other than parent/guardian) *

Emergency Contact Phone Number 1*

Emergency Contact Phone Number 2

Does the camper have any allergies?*

YesNo

If so, please list here:

Insurance Information- Please list: 1. Name of Insurance Provider 2. Policy Number 3. Physician's name 4. Physician's Phone Number*

Does the camper have any medical issues we need to be aware of?*

YesNo

If so, please list here:

ACTIVITIES COVERED: This release covers all aspects of participation at camp, including but not limited to: transportation to and from the event site(s) by car or van, kayaking or canoing on lake or ponds, swimming and wading in rivers, ponds, or lakes, camping, including use of tents, cooking over open fires, and outdoor living, hiking, climbing, or exploring rugged or uneven terrain, jumping or diving into water, fishing, archery, use of guns, axe throwing, general outdoor recreation and physical activity, and unforeseen or spontaneous activities that may arise during the trip*

Accept

ACKNOWLEDGMENT OF RISKS: I acknowledge and understand that these activities involve inherent risks, including but not limited to: drowning, hypothermia, or injury from water hazards, falling or injury due to rough or slippery terrain, insect bites, exposure to wildlife, and environmental dangers, heat exhaustion, sunburn, or dehydration, vehicle accidents during transportation, equipment failure or misuse, accidents due to the actions of others or unforeseen circumstances; I understand that these risks may result in serious injury, illness, permanent disability, emotional trauma, or even death.*

Accept

RELEASE AND WAIVER: I, on behalf of myself, my child (if applicable), and our heirs, successors, and assigns, hereby: Release Father’s Tracks from any and all liability, claims, demands, actions, or causes of action for any injury, loss, damage, or death arising from or related to participation in the camp and waive any right to sue or make a claim against Father’s Tracks, including for alleged negligence, breach of duty, or unsafe conditions.*

Accept

ASSUMPTION OF RISK: I voluntarily and knowingly assume all risks associated with participation in the trip, whether known or unknown, and regardless of how they are caused.*

Accept

INDEMNIFICATION: I agree to indemnify and hold harmless Father’s Tracks from any loss, liability, damage, or cost (including attorney fees) arising from participation in the trip, including claims brought by third parties or other participants.*

Accept

MEDICAL AUTHORIZATION: I authorize Father’s Tracks to provide or seek emergency medical care for myself or my child if necessary. I understand I am financially responsible for any such care.*

Accept

MEDIA RELEASE: I grant permission for Father’s Tracks to use photographs, video, or audio recordings taken during the trip for promotional, educational, or social media purposes without compensation or further permission.*

Accept

Parent/Guardian's Signature*

Date Signed*

Date

Payment*

Registration

$150.00

Total

$0.00

Credit Card Details
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