2026 Brown Girl J.O.Y (Journey of Yourself) Registration

2026 Brown Girl J.O.Y (Journey of Yourself) Registration Form
- NOTE:
  
  REGISTRATIONS RECEIVED AFTER JULY 17, 2026
  
  ARE NOT GUARANTEED A
  
  BROWN GIRL J.O.Y. T-SHIRT AND/OR ALL SWAG ITEMS!
- Camper First Name:
- Camper Last Name:
- Grade
  Grade entering for 2026-27
- School
  School attending for 2026-27
- Age (as of July 24th)
- Address
  
  Street Address
  
  CityState / Province
  
  Postal / Zip Code
- Email
  example@example.com
- Phone Number (cell preferred)
  Please enter a valid phone number.Format: (000) 000-0000.
- T-Shirt Size
  
  Other Adult Size _________
- Day(s) Attending (Pick 1 or 2 options):
  
  Other (Enter Day & Exact Time)_____________________
- Parent/Guardian First Name
- Parent/Guardian Last Name
- Parent/Guardian Cell Phone Number
  Please enter a valid cell phone number.Format: (000) 000-0000.
- Parent/Guardian Email
  example@example.com
- Alternate Contact First Name
- Alternate Contact Last Name
- Alternate Contact Cell Phone Number
  Please enter a valid cell phone number.Format: (000) 000-0000.
- Alternate Contact Email (Optional)
  example@example.com
- I, the undersigned parent/guardian, do hereby grant permission for my daughter, named above, to attend the camp. In order that my child may receive the proper medical treatment in the event that she may sustain injury or illness during Brown Girl J.O.Y. presented by the DEED Foundation, I hereby authorize the camp volunteers to obtain or provide medical treatment for my child for such injury or illness during the camp, and I hereby hold the camp volunteers and sponsoring organization (s), as well as its representatives, harmless in the exercise of this authority.
  Initials
- If medical care is deemed necessary and I cannot be contacted, I authorize Brown Girl J.O.Y. and the DEED Foundation volunteers to act on my behalf in deciding the proper course of action for my camper. This includes but is not limited to permission for Brown Girl J.O.Y. and the DEED Foundation to render any emergency medical treatment that Brown Girl J.O.Y. and the DEED Foundation volunteers deem appropriate and/or necessary for the well-being of my camper, including, but not limited to First Aid, CPR, calling emergency ambulance transportation and hospitalization, if necessary.
  Initials
- I understand and agree that any and all actions taken by Brown Girl J.O.Y. and the DEED Foundation for the benefit of my camper comes at my cost, including but not limited to, emergency medical treatment or care and ambulance transportation. I promise to hold Brown Girl J.O.Y. and the DEED Foundation harmless and indemnify Brown Girl J.O.Y. and the DEED Foundation for any and all costs associated with any medical treatment it has deemed necessary and/or appropriate for the well-being of my camper, including, but not limited to, any and all costs associated with emergency room visits, hospital care, and ambulance services.
  Initials
- Brown Girl J.O.Y. and the DEED Foundation has put in place preventative measures to reduce the spread of COVID-19; however, Brown Girl J.O.Y. and the DEED Foundation cannot guarantee that you or your child will not become infected with COVID-19. Further, attending activities at Brown Girl J.O.Y. and the DEED Foundation could increase your risk and your child's risk of contracting COVID-19. With full knowledge of the risks involved, I hereby release, waive, discharge Brown Girl J.O.Y. and the DEED Foundation, its board, officers, independent contractors, affiliates, employees, representatives, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me/my child related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19.
  Initials
- I specifically release Brown Girl J.O.Y. and the DEED Foundation from any and all claims, loss, costs, damage, or expenses arising out of or from the exercise of their discretion in seeking medical treatment on behalf of my camper as Brown Girl J.O.Y. and the DEED Foundation may deems necessary and/or appropriate, and also release Brown Girl J.O.Y. and the DEED Foundation from any and all claims, losses, costs, damages, and/or expenses associated with any negligent treatment or medical malpractice committed by any medical professional, which I might otherwise pursue against Brown Girl J.O.Y. and the DEED Foundation in whole or part, including joint or several liability.
  Initials
- MEDICAL CONCERNS (Please list all medical concerns):
- ALLERGIES (Please list all allergies):
- SPECIAL NEEDS (Does your camper have any special needs that should be recognized?)
- What special accomodations or modifications are needed?
- I hereby assign to Brown Girl J.O.Y. and the DEED Foundation the right to record my child’s voice and likeness for use in media productions. Brown Girl J.O.Y. and the DEED Foundation has absolute right and permission to copyright and/or publish photographic portraits or pictures of my child through any media at their disposal for art, advertising, trade or any other lawful purpose whatsoever.
  Initials
- I hereby waive any right that I may have to inspect and/or approved the finished product or the advertising copy that may be used.
  Initials
- I hereby release, discharge, and agree to SAVE Brown Girl J.O.Y. and the DEED Foundation and all affiliates, from any liability by virtue of any blurring, distortion, altercation, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said pictures.
  Initials
- The goal of this policy is not to set up consequences or punishments for campers when they misbehave, but rather to establish positive expecatons for camper behavior. A second goal of this policy is not only to address the outward behavior of the campers, but to also transform their hearts and minds so they understand how to interact with others.
  
  The rules of the camp are reflected in these three (3) principles:
  
  1. Safety
  
  2. Respect Property of the Camp and of Others
  
  3. Have Fun
  
  Disciplinary Actions:*
  
  First Offense: Offense noted and conversation with a Camp Volunteer.
  
  Second Offense: Camper will be restricted from some camp activities. A call will be made to the parent/guardian to inform them of their camper's behavior at the camp.
  
  Third Offense: Camper will be removed from camp activities. Parent/guardian will be called to pick up their camper.
  
  *Any of these steps may be skipped at the discretion of the camp volunteer based upon the frequency and severity of the camper’s misbehavior.
- I understand the goals, principles, rules, and disciplinary actions outlined in the Behavior Management and Discipline Policy.
  Initials
- In consideration of being permitted to participate in activities for the Brown Girl J.O.Y. camp, the undersigned, for herself and any personal representatives, heirs, and next of kin, hereby agrees to the following:
- THE UNDERSIGNED HEREBY RELEASES, WAIVES, DISCHARGES, AND COVENANTS NOT TO SUE Brown Girl J.O.Y. and the DEED Foundation, its officers, employees, agents, and representatives (hereinafter referred to as "releasees") from all liability to the undersigned, his personal representatives, assigns, heirs, and next of kin for any loss or damage and any claims or demands therefore on account of injury or death of the undersigned or property loss or injury, whether caused by the negligence of the releasees or otherwise, while the undersigned is participating in Brown Girl J.O.Y. and the DEED Foundation activities.
  Initials
- THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them from any loss, liability, damage, or cost he or she may incur due to the undersigned's participation Brown Girl J.O.Y. and the DEED Foundation Camp activities whether caused by the negligence of the releasees or otherwise.
  Initials
- THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE due to the negligence of releasee or otherwise while participating Brown Girl J.O.Y. and the DEED Foundation. THE UNDERSIGNED further expressly agrees that the foregoing RELEASE, WAIVER, AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the law of the State of Missouri and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
  Initials
- THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements, or inducements apart from the foregoing written agreement have been made.
  
  My signature acknowledges receipt, understanding and agreement with all sections of the Parent Agreement. This agreement may be executed in one or more counterparts, all of which taken together shall constitute one instrument. A facsimile or other electronic copy of a signature on this Agreement shall be acceptable as and deemed to be an original signature.
- Parent/Guardian First Name
- Parent/Guardian Last Name
- Signature
- Date Completed:
  
  MonthDayYear
  Date
Should be Empty:

2026 Brown Girl J.O.Y (Journey of Yourself) Registration Form