LifeLab Durham Teen Camp Registration & Liability Waiver

LifeLab Durham Teen Camp Registration & Liability Waiver

Complete the registration details, required permissions, and e-sign the legally binding waiver for LifeLab Durham (Aug 10–14, 2026).
Participant Information
Participant Full Name

First NameLast Name
Participant Date of Birth

MonthDayYear
Date
Participant Age (must be 15–18 at camp start)
Participant Email Address
example@example.com
Participant Cell Number (or parent/guardian if teen doesn't have a phone)
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Information
Parent/Guardian Full Name

First NameLast Name
Relationship to Participant
Parent/Guardian Email Address
example@example.com
Parent/Guardian Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Information
Emergency Contact Full Name

First NameLast Name
Emergency Contact Relationship
Emergency Contact Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information
Does the participant have any allergies?
If yes, please list all allergies:
Does the participant have any medical conditions?
If yes, please describe the condition(s):
Is the participant currently taking any medications?
If yes, please list medications and dosages:
Please list any other health concerns or special needs:
Authorized Pickup Adults
Authorized Pickup Names (separate multiple names with commas)
Liability Waiver & Release
Please read the full LifeLab Durham Liability Waiver before signing:

https://lifelabdurham.com/waiver.pdf

Open and read it in full before proceeding. By initialling and signing below, you confirm you have read and agree to all terms.
Initial here to confirm acceptance of the liability waiver:
Photo/Media Release
I grant permission for photos/video of the participant to be used for promotional purposes.
Code of Conduct Agreement
All participants are expected to: • Treat staff, volunteers, and fellow participants with respect and kindness at all times • Follow all safety instructions and program rules without exception • Participate actively and honestly in all scheduled Activities • Refrain from bullying, harassing, or disrespectful behavior toward others • Not possess or use alcohol, tobacco, drugs, or weapons of any kind • Wear closed-toe shoes (REQUIRED for all Activities for safety reasons) • Wear clothing appropriate for weather and scheduled Activities • NOT use personal electronics including phones, tablets, gaming devices, headphones, or smartwatches during scheduled Activities or off-site community visits except with staff permission for emergencies or parent/guardian contact • NOT share personal information (email address, phone number, social media handles, home address) with any community members, volunteers, or outside contractors at off-site locations • NOT engage in any form of harassment based on sexual orientation, gender identity, race, ethnicity, native language, or socio-economic status • Return to program location at designated times; unauthorized departures are not permitted CONSEQUENCES: Violation of this Code of Conduct may result in immediate dismissal from the program WITHOUT REFUND. Serious violations including violence, threats, weapons, illegal substances, or sexual misconduct may be reported to law enforcement. Participant should not attend if they have a fever, vomiting, or symptoms of a contagious illness. LifeLab Durham is not responsible for lost, stolen, or damaged personal belongings.
I have read the Code of Conduct above, discussed it with my child, and confirm that they understand and agree to abide by these rules.
Initial here to confirm acceptance of the Code of Conduct:
Transportation & Off-Site Authorization
I authorize LifeLab Durham staff to transport my child for camp activities.
Cancellation & Refund Policy
50% refund if cancelled before July 11, 2026. No refund if cancelled on or after July 11, 2026. No refund for dismissal due to Code of Conduct violations. Stripe payment processing fees are non-refundable in all circumstances.
I have read and understand the cancellation and refund policy.
Initial here to confirm acceptance of the cancellation/refund policy:
Final Signature
Signature (Parent/Guardian)
Camp fee for LifeLab Durham, August 10–14, 2026. Payment is non-refundable after July 11, 2026.

LifeLab Durham Teen Camp

5 day teen life skills camp

$375.00

Total

Payment Methods

Debit or Credit Card

ACH Bank Transfer

Should be Empty:

LifeLab Durham Teen Camp Registration & Liability Waiver

Participant Information

Parent/Guardian Information

Emergency Contact Information

Medical Information

Authorized Pickup Adults

Liability Waiver & Release

Photo/Media Release

Code of Conduct Agreement

Transportation & Off-Site Authorization

Cancellation & Refund Policy

Final Signature