Rumbling Bald Summer Camp Registration Form

We are thrilled to welcome you and your child to our Rumbling Bald Summer Adventure Day Camp! Ages 4 years - 13 years of age. Our day camp is designed to provide children with a safe and engaging environment to learn and have fun during the summer. We have planned a wide range of exciting activities, sports, arts and crafts, nature exploration, field trips, and more. All campers are together all day and are separated only for ‘age-based’ activities, such as sports days. Our calendar lists the ‘featured activity’ for the day. While each day will offer age-range games, crafts, swimming, and more, campers will spend extra time on their feature activities.

Please note:This is not a reservation for Summer Camp.
Filling out the information below will not guarantee you a reservation for camp.
You must call the Wellness Center, during normal business hours, and make your reservations and payments over the phone, or in person.

Summer Camp runs rain or shine .

Camper Information

Camper Name*

First NameLast Name

Camper Birth Date*

MonthDayYear

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name*

First NameLast Name

Cell Number*

E-mail*

example@example.com

Rumbling Bald Summer Adventure Camp is only open to members and lodging guests. If you are not an active member, or staying on property, you may not register for Summer Adventure Camp.

If you are a lodging guest please type "Lodging Guest" in the above line.

If you are a VRI or Wyndham Timeshare owner please type "TimeShare"

Lodging Guest or Timeshare Owner*

Please type *LG* for lodging guest. Please type *Timeshare* for VRI or Wyndham Owners.

Rumbling Bald - Member # or Associate #*

Please type in your Rumbling Bald homeowner # ex: 12455S or Associate #

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Alt. Phone Number*

Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.*

Is the camper prescribed an inhaler? If yes, please explain any instructions.*

Photography agreement*

My child CAN be photographedMy child CANNOT be photographed

Potty Trained Acknowledgement

I hereby verify that my child, no matter the age, is potty trained. Meaning they can go to the restroom by themselves and will not need any assistance from our staff. They will not be given any assistance from our staff during changing times or bathroom breaks.

I acknowlegde that if my child comes to camp, under the assumption they are potty trained, and our staff determines they are not, they will be sent home and no refund will be given.

Initial of parent/guardian*

Electronic Device Acknowldgement

I understand that there are to be no electronic devices, such as, but not limited to, iPad, phones, gaming devices or laptops, while at camp.

I understand that if my child brings an electronic device to camp, that Rumbling Bald, or any of its employees, are not liable for any damage that may occur to the electronic devices.

I understand that my child’s electronic devices may be confiscated by a Rumbling Bald staff member, if the device is causing a distraction, and the device will be returned to the parent/guardian at the end of the camp day.

Initial of parent/guardian*

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Rumbling Bald during the selected day/night. In exchange for the acceptance of said child’s candidacy by Rumbling Bald, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Rumbling Bald 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 Rumbling Bald including all counselors 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.

Initial of parent/guardian*

Medical Release and Authorization

As Parent and/or Guardian of the named counselor, 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 Rumbling Bald and its affiliates including Directors, Counselors, and other staff members 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.

Initial of parent/guardian*

Member Card & Guest Passes

Rumbling Bald on Lake Lure Summer Camp is not open to the public. By initialing below, you understand that at the time of drop off, a valid Member Card or Guest Pass is required in acorace to Rublimg Bald on Lake Lure guest and Member policy.. For those campers 12 - 13 years of age, a guest pass or member card must be presented for them, in addition to the guardians Member Card or Guest Pass.
Failure to provide the items listed above, will result in your camper not being able to attend, and no refund will be issused.

Cancellation Policy

All cancellations must be submitted in e-mail format to celam@rumblingbald.com or mjohnson@rumblingbald.com.
Cancellations must be made 48 hours prior to the camper’s start date, with a 50% refund being given.
Cancellation made within 24 hours of the camper's start date, will not be issued a refund.
However, with a doctor’s written verification, due to a medical cancellation, prior to the start of the camper's start date, a full refund may be given.

In order for your child to attend Rumbling Bald Summer Camp, this form must be completed prior to reservations. Payment, in full, is required at the time of booking. *

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*

Date

Signature*