• Register for Camp!

  • Emergency Contact

  • Format: (000) 000-0000.
  • Medications and Activities

  • Medications taken regularly (must be in original container), all medicines must be in a plastic bag labeled with the child's name. All medications will be administered by the camp director.

  • Signatures

  • IN CASE OF AN EMERGENCY, I HEREBY GIVE PERMISSION TO THE CAMP DIRECTOR TO SECURE PROPER TREATMENT AS NEEDED FOR MY CHILD/REN. PARENTS WILL BE NOTIFIED IN CASE OF AN EMERGENCY.


    PHOTO RELEASE: I grant my permission to Escape to the Mountain Youth Camp to Photograph or Video tape my child/ren while at camp. Escape to the Mountain Youth Camp will use them solely for the purpose of promoting the camp.

  • Date
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  • Code of Conduct: I must have a good relationship with others. Language, name calling, touching other campers in any way will not be tolerated. If I choose to do any of the above, I will be sent home immediately. I must follow the safety rules set in place by the staff for each activity that I participate in.

    We make every effort to provide a safe environment, and activities are not without risk but, following the guidelines and adhering to them is for my safety.

  • Date
     - -
  • Should be Empty: