Camp Registration Form

Name

First NameLast Name

Gender

MaleFemale

Birth Date

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Grade entering in the fall

Name

First NameLast Name

Gender

MaleFemale

Birth Date

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Grade entering in the fall

Name

First NameLast Name

Gender

MaleFemale

Birth Date

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Grade entering in the fall

Name

First NameLast Name

Gender

MaleFemale

Birth Date

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Grade entering in the fall

Please select a camp week

Week 1: January youth javelina hunt 22-25Week 2: General javelina hunt February 19-22Week 3: April 11 HikeWeek 4: Youth Adventure camp June 19-22Week 5: Family Fishing camp July 17-20Week 6: Archery camp August 27-30Week 7: Youth Deer camp October 8-11Other (Dream Trips)

Which camp would you/your child like to attend

Weekend Family CampsSkills OutingsAdventure CampsDream trips

Parent/Legal Guardian*

Relation*

Work Phone

Area CodePhone Number

Cell Phone

Area CodePhone Number

Home Phone

Area CodePhone Number

Emergency Contact Name(if parent or guardian is not avaliable)*

Emergency Number*

Area CodePhone Number

Emergency Number #2*

Area CodePhone Number

Parents Email (camper confirmation will be sent by email, if left blank it will be mailed)

Camper's Email

How did you hear about IWO camps?

First Time Camper? (If yes, subtract $25 from camper fee if applicable)*

YesNo

Date of last tetanus shot

Any activity the camper should be restricted from?

Any physical, mental or other condition that would require special attention or medication while at camp?

List all medications, both prescribed and over the counter, all medications will be turned into the health officer except rescue inhalers, bring all medication in original containers.

List any allergies (ex: bees,peanuts, dairy)

Any dietary needs that we should know about?

I agree that photos of my child/family can be taken on used on for camp social media purposes

YesNo

Method of payment

Be certain to enter your email address correctly on the registration form to receive confirmation via email with in 2 weeks

Release of Liability and Assumption of Risk

I, the undersigned parent or legal guardian, understand that participation in Into the Wild Outdoors, Inc. programs—including hunting, fishing, hiking, camping, shooting sports, and all outdoor activities—involves inherent risks of injury, illness, property loss, or even death. I voluntarily assume full responsibility for all participants listed above and release Into the Wild Outdoors, Inc., its directors, staff, volunteers, and partners from any liability or claims resulting from participation in these activities.
I affirm that all participants listed are physically able to participate and agree to abide by all safety rules and instructions provided by staff and volunteers.

Medical Consent

In the event of an emergency and if I cannot be reached, I authorize Into the Wild Outdoors, Inc. staff or representatives to seek medical attention for any participant listed above. I accept financial responsibility for any medical care provided.

Media Release Consent
I grant permission to Into the Wild Outdoors, Inc. to photograph, video, or record any participants listed above during the course of camps, fishing trips, hikes, shooting sports, and other events. These media may be used in promotional materials, websites, social media, newsletters, and digital publications. I understand no compensation will be provided and all rights to the media belong to Into the Wild Outdoors, Inc.

By hitting submit and putting your initials, I, the undersigned parent or legal guardian, understand that participation in Into the Wild Outdoors, Inc. programs including hunting, fishing, hiking, camping, shooting sports, and all outdoor activities involves inherent risks of injury, illness, property loss, or even death. I voluntarily assume full responsibility for all participants listed above and release Into the Wild Outdoors, Inc., its directors, staff, volunteers, and partners from any liability or claims resulting from participation in these activities.
I affirm that all participants listed are physically able to participate and agree to abide by all safety rules and instructions provided by staff and volunteers. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activites.

Electronic signature, please initials*

Camp Registration

Camper's Information

Parent or Legal Guardian Information

Emergency Contact Info

Email Confirmation

Other Information

Health Information

Campers Photo Release

Payment Information