Day Camp Application

Day Camp Application
Camper Information
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Grade
The grade your student will be going into for the 2026-2027 school year.
Gender
School
What week(s) will your child be attending camp?
Parent/Guardian Details
Parent/Guardian Name

First NameLast Name
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Emergency Contacts
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Camper
Permission to Pick up
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Camper
Permission to Pick up

Health & Medical
Allergies/Dietary Restrictions
Type n/a if no known allergies
Current medications
Type n/a if not taking any medications currently. , Guardian will be required to fill out a form for medication at drop off.
Any known medical conditions
Type n/a if none
In the event that I, or my designated emergency contacts, cannot be reached immediately, I authorize any licensed physician, dentist, or emergency medical personnel to provide emergency care, diagnostic procedures, medication, surgical treatment, and hospitalization as deemed necessary for my child’s health and safety. I understand that reasonable attempts will be made to contact me, but I waive the right to be consulted prior to necessary emergency medical treatment. I accept full financial responsibility for all medical services rendered. I confirm all medical information provided in this application (including allergies and conditions) is accurate and grant this authorization effective for the duration of the program/camp.
Signature

Authorization for emergtency medical treatment
Vaccination Records
Please upload your camper's current Vaccination Records or Certificate of Medical or Non Medical Exempt Forms below:

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Please upload a letter of health from primary physician stating that your child is healthy enough to participate in camp activities.

Cancelof
Child's Physician Name
Preferred Hospital
Child's Dentist Name

Permission & Waivers
Optional Photo Waiver

I hereby grant to the Museums of Western Colorado the permission to use {name} likeness in a photograph, video, or other digital media ("photo") in any and all of its publications, including web-based publications, without payment or other consideration and to alter and composite the same without restriction and without my inspection or approval. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

I hereby hold harmless, release, and forever discharge the Museums of Western Colorado from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I have read and understand the above photo release and affirm that I am at least 18 years of age.
Signature

I have read and understood the media release.
I do not wish to have my child in any media/photographs.

Behavior Code of Conduct & Agreement

Dinosaur Journey Summer Camps
I. Student Code of Conduct

We expect all campers to practice physical and emotional safety; to respect others, including fellow campers, counselors and camp staff; and to follow rules outlined on the first day of camp. Please review and sign these with your child in the weeks leading up to the camp session.

The Dinosaur Journey Camp staff will implement the following rules to keep staff and children safe:
- Stay within adult supervision.
- No foul language, bullying or name-calling.
- Respect the property of others and Dinosaur Journey.
- Be courteous and respectful to others.
- Respect the outdoor spaces you visit.
II. Parent/Guardian Code of Conduct
- Partnership: I will work with teachers to support my child's education.
- Communication: I will address concerns with staff in a constructive, respectful, and private manner.
- Respect: I will model respectful behavior on camp premises.
- Safety & Policies: I will adhere to camp safety protocols, including check-in procedures.
- Violations of this agreement may result in:
III. Consequences of Misbehavior
- Verbal warning and discussion.
- Behavior note/incident report sent home.
- Parent-camp director conference.
- Removal from activity or termination of enrollment (for severe/continued behavior).
IV. Agreement Signature

By signing below, I acknowledge that I have read, understand, and agree to abide by this Code of Conduct.
Student Signature
Parent/Guardian Signature

Field Trip Permission
I give permission for my child to participate in scheduled field trips and transportation provided by the program.

Transportation will be provided using vehicles owned and insured by the organization and driven by authorized staff.
Signature
Sunscreen Authorization
Signature
Should be Empty:

Day Camp Application

Camper Information

Parent/Guardian Details

Emergency Contacts

Health & Medical

Vaccination Records

Permission & Waivers

Behavior Code of Conduct & Agreement

Field Trip Permission

Sunscreen Authorization