Camp Registration Form

Camp Registration Form

Please fill out your details to register for the camp.
A completed Summer Camp Intake & Liability Form must be submitted and approved prior to participation. One form will remain valid for all Summer Camp sessions from May 21, 2026 through August 10, 2026 unless updated information is required.
Participant Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does the participant have any medical conditions, allergies, injuries, or physical limitations?
If YES, to any medical conditions, allergies, injuries, or physical limitations please explain:
I hereby grant permission for the non-profit An Active World, Inc. and Energy Fitness of America to photograph and/or record my child during camp activities for promotional, educational, marketing, and community outreach purposes. I understand that these images and recordings may be used in print, digital media, social media, websites, and other promotional materials without compensation.
Authorization & Consent

I, the undersigned parent/legal guardian, authorize my child to participate in the Energy Fitness of America Summer Performance Camp activities, including fitness training, conditioning, speed & agility exercises, recreational activities, and related camp programming.

I understand that participation in physical activities involves inherent risks, including but not limited to falls, injuries, illness, or other unforeseen incidents. I voluntarily assume all risks associated with participation.

I hereby release and hold harmless Energy Fitness of America, its owners, staff, trainers, volunteers, and affiliates from any liability, claims, demands, injuries, damages, or expenses arising from participation in camp activities, except in cases of gross negligence.

I certify that my child is physically able to participate in camp activities.
Camp Policies Acknowledgement

By signing below, I acknowledge and agree that:
- Camp registration must be completed in advance
- One courtesy transfer may be allowed for missed sessions based on availability
- No-call/no-show sessions are forfeited without refund or credit
- Repeated no-call/no-show incidents may result in denied future participation
- Camp fees are non-refundable unless otherwise approved by management
Signature
Should be Empty: