Mountain Kids, Inc.

Parent/Guardian Information

Emergency Information

Camp Registration Information

We are excited to offer a variety of camps for varrying ages this summer!  Please select the camps in which your child wishes to participate.  At this time, each camp has a maximum of 30 campers.  After registration, you will receive an email with payment information, or a notice of being placed on the waitlist.  We are using a new system this year, so please bear with us as we navigate together. 

Registration Fee

A $50 nonrefundable registration fee is required for each camp you select for your camper.  An invoice will be sent thruogh email within 14 days of registration.  This deposit/s paid will be deducted from you camper's total tuition for Summer 2026.

 

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Mountain Kids, Inc., during the selected camp. In exchange for the acceptance of said child’s candidacy by  Mountain Kids, Inc., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Mountain Kids, Inc. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Mountain Kids, Inc. including all staff, volunteers, and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all camp activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Non-Discrimintory Policy

Mountain Kids, Inc. is a 501(c)3 nonprofit organization, with the mission, "To improve the lives of children in and around Tazewell County, Virginia."  We strive to be an equal opporunity charitable organization, committed to providing an environment that is free from discrimination.  This includes areas such as volunteerism, contributions, and support.  We will welcome and consider qualified applicants without regard to sex, race, color, religion, ethnic or national origin, gender, sexual orientation, gender identity or expression, age, pregnancy, disability, and/or any other characteristic or status that tis protected by national, federal, state, or local law.

Mountain Kids, Inc. works together with other nonprofits, community organizations, churches, funders, and stakeholders to enrich our local community, by building the capacity of the community through services for educational enrichment. ​We believe our mission may be effectively fulfilled with a commitment to diversity and inclusiveness and a core practice and value. ​We aim to lead by example, by encouraging diversity as a fundamental strength of our organization. 

CONFIRMATION of INFORMED CONSENT AND ACKNOWLEDGEMENT AND NON-DISCRIMINATORY POLICY

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Medical Release and Authorization

As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Mountain Kids, Inc . and its affiliates including Directors, Staff, Volunteers, and other representatives of the organization, to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

I agree that if my dependent or I (heretofore known as "we") engage in any physical activity, class, or activity, or facility on the premises or any venue where we participate as a representative of Mountain Kids Incorporated, we do so at our own risk. I agree that we are voluntarily participating in activites and use of said facilities, premises (including the parking lot) and designated Mountain Kids Incorporated venues. We assume all risk of injury, illness, damage, or loss to us or our personal property that might result, including, without limitation, any loss or theft of any personal property. I agree that this consent and assumption of risk statement covers each and every event or activity sponsored by Mountain Kids, Incorporated. I agree to release and discharge you (and your affiliates, employees, assistants, volunteers, agents, representatives, successors, and assigns) from any and all claims or cause of action (known or unknown) arising out of your negligence. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability. I am waiving any right that I may have to bring legal action to assert a claim against you for negligence.

CONFIRMATION of MEDICAL RELEASE AND AUTHORIZATION

I confirmn the health history provided is correct and accurately reflects the health status of the camper to whom it pertains.  The person described has permission to participate in all camp activities except as noted by me/or an examining physician.  I give permission to the physician selected by the camp to order x-rays, routine tests, and treatment related to my camper's health for both routine health care and emergency situations.  If I cannot be reached in an emergency, I give my permission to the physician to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for this camper.  I understand the information on this form will be shared with camp staff on a "need to know" basis.  I give permission to photocopy this form.  In addition, the camp has permission to obtain a copy of my camper's health record from providers who treat my camper, and these providers may talk with the program's staff about my camper's health status.

BY ACKNOLWEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE.  THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.