Lockerly Arboretum Summer OAK Camp

Lockerly Arboretum Summer OAK Camp
Camper Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender
Birthday

MonthDayYear
Date
Grade in September 2026
Summer Camp Sessions

Oak Camp (rising 4th to 6th) June 15-18Oak Camp (rising 4th to 6th) June 22-26Oak Camp (rising 4th to 6th) July 13-17
Camp T-Shirt Size (included in registration cost)

Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult Large
Food Allergies
Environmental Allergies
Medical Conditions
Prescriptions
Other Medical Information
Contact Information
Primary Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Relationship to Camper
Secondary Contact

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Relationship to Camper
Waiver and Release Form
Liability Release

I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to my child as a result of participation in said event. This release is intended to discharge in advance Lockerly Arboretum, its officials, officers, employees, volunteers and agents from liability.

Parental Consent

I give consent for my child to participate in the above activities, and I execute the above liability release on their behalf. By signing this document, I authorize Lockerly Arboretum to publish photographs taken of me and/or my minor child(ren), and our names, for use on the Lockerly Arboretum website, social media and print materials.
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Date

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Date
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Lockerly Arboretum Summer OAK Camp

Camper Information

Contact Information

Waiver and Release Form