Camp Regisration Form

Please fill the details below in order to REGISTER to Camp

Parents Information (Sub Section)

Parent 1 First Name

Parent 1 Last Name

Parent 1 Phone Number

Parent 2 First Name

Parent 2 Last Name

Parent 2 Phone Number

Camper Info

First name

Last name

Gender

Multi-line address

Country/Region

Address

City

Zip / Postal code

Health Insurance Information

Physician Name

Physician Phone

Insurance Policy Number ID

Health Insurance Provider

Any Allergies?

Any Dietary Restrictions

Any Medications currently administered

Requird Medical Documentation (Sub Section)

The following medical documentation is required for all campers.

The documentation must be provided to Camp Registrar within 3 weeks of this application submission or 2 weeks prior to start of Camp, whichever is first.

If this medical documentation is not submitted in timely manner, Camp Registrar has discretion to deny entry to Camp.

Copy of BOTH sides of the applicable health insurance card
Copy of attendee's most recent Immunization Record
Signed statement from physician that attendee is in good physical condition to participate in all Camp activities.

You may submit the required medical documentation via email to the camp contact information: dharmaawakeningfoundation@gmail.com

Medical Acknowledgement (Sub Section)

The medical health information that is provided for each attendee in this form is correct and current to the best of my knowledge.

Each attendee is able, willing, and has the permission to participate in all Camp activities unless otherwise noted and approved by Camp Doctor.

Each attendee must submit to Camp Registrar required medical documentation to Camp Registrar within 3 weeks of this application submission or 2 weeks before camp starts, whichever comes first.

The attendee will notify the Camp Doctor if there is any change in attendee's health from time of form submission until start of Camp.

Permission is given to Camp Doctor to:

Hospitalize and/or administer proper treatment including but not limited to anesthesia, surgery, and any necessary transportation.
Treat minor injuries or illness; administer, as specified in this form, prescription medication from its original container that is labeled with attendee's name, attendee's physician, and dosage; administer over-the-counter medication unless otherwise specified in this form.

I have read and agree with the Medical Acknowledgement as stated above.

Attendance Acknowledgement (sub section)

Each parent has read the Rules and Regulations of Camp and will adhere to said rules and regulations for duration of Camp.

Each camper must stay at Camp for the duration of Camp.

If it is necessary to be absent from Camp for part of the week, Camp organizers must be notified and obtain permission.

Having all attendees present in Camp ensures safety and ensures that Camp is successful.

I have read and agree with the Attendance Acknowledgement as stated above.

I give permission to Camp staff and/or persons authorized by Camp Director to use pictures and/or videos that may include attendees in this application for Camp promotional purposes.

I give permission to use pictures and/or videos

Refund Policy Acknowledgment (subsection)

Full paid amount minus $35 for each attendee will refunded if Camp organizer is notified by email at least 3 weeks prior to start of Camp.

Full paid amount minus $75 for each attendee will be refunded if Camp organizer is notified by email between 3 and 2 weeks prior to start of Camp.

No refund will be given for any attendee who does not attend Camp or if Camp organizer is notified by phone or email within 14 days of start of Camp.

I have read and understand the refund policy