Clone of 2026 Summer Camp Registration Form

Summer Camp Registration

Washougal School District || July 13th - July 16th
Camper Information
Camper's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Gender
Camper Shirt Size
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Format: (000) 000-0000.
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement

SWCA CONSTRUCTION SUMMER CAMP: CAMPER/CHILDREN RELEASE and WAIVER of LIABILITY and INDEMNITY AGREEMENT

In the event of an emergency, I grant permission for emergency medical treatment

to be given and I agree to pay all medical bills not covered by the insurance company listed on my child's registration form. I release the Washougal School District from being responsible for any bills resulting from injuries incurred in these programs. I have listed information regarding allergies or other medical conditions about my child or myself of which staff should be aware.

I will communicate my student's potential medical/medication needs with

the onsite staff and/or event coordinator(s). I, intending to

be legally bound, waive and release my rights and claims for damages I may

accrue against any and all sponsors of this program.

IN FURTHER CONSIDERATION OF PARTICIPATING IN SWCA’S SUMMER CAMP, FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:

1.     THE UNDERSIGNED ON HIS OR HER BEHALF AND BEHALF OF SUCH CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the SWCA or the Washougal School District, or Participating Sponsors and all branches thereof, its directors, officers, employees, and agents (hereinafter referred to as "releasees") from all liability to the undersigned or such children and all his personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefor on account of injury to the person or property or resulting in death of the undersigned or such children whether caused bv the negligence of the releasees or otherwise while the undersigned or such children is in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with the SWCA and Washougal School District.

2.     THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them from any, loss, liability, damage or cost they may incur due to the presence of the undersigned or such children in, upon or about the summer camp location.

3.     THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned or such children due to negligence of releasees or otherwise while in, about or upon the summer camp location/or while using the premises or any facilities or equipment thereon or participating in any program affiliated with the SWCA or Washougal School District.

4.     THE UNDERSIGNED HEREBY UNDERSTANDS THAT PHOTOS of myself or my family, taken as we participate in SCWA Summer Camp activities, may be used for online and print SWCA Summer Camp promotional purposes.
Confirmation

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.
Date

MonthDayYear
Date
Signature
Registration Fee
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Camper Registration

$99.00

Total

$0.00
Should be Empty:

Summer Camp Registration

Camper Information

Registration Fee*

Registration Fee