Camp Explore 2024 Registration Form Link Below: https://www.cognitoforms.com/TahoeFamilySolutionsCampExplore/CampExploreRegistration2024 Camp Explore 2024 Enlace del formulario de registro a continuación: https://www.cognitoforms.com/TahoeFamilySolutionsCampExplore/CampExploreRegistration2024 Want to Support Camp Explore? Donate Here: Donation Amount
Your tax-deductible contribution will bring many wonderful memories and wilderness-based experiences to our local youth. Contributions of all levels are welcome.
TOTAL
$0.00
Credit Card Billing Address
Prefer to Donate by Check? / ¿Prefiere donar con cheque? Mail or drop off check to the Tahoe Family Solutions office:
774 Mays BLVD., #13 Incline Village, NV 89451
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Child's Name*
First
Last
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Date of Birth*
MM slash DD slash YYYY
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Sex* This field is hidden when viewing the form
T-Shirt Size* Select Youth XS Youth S Youth M Youth L Youth XL Adult XS Adult S Adult M Adult L Adult XL
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Swimming Ability* Select None Beginner Proficient
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Grade Level* Completed Grade by end of June 2022
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Camp Sessions Attending 3rd & 4th Grade – ONE WEEK PER CHILD Please Select One Session Per Child. Only sessions that apply to your child’s grade group are displayed.
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Camp Sessions Attending 5th-6th Grade – ONE WEEK PER CHILD Please Select One Session Per Child. Only sessions that apply to your child’s grade group are displayed.
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Camp Sessions Attending 7th-8th Grade – ONE WEEK PER CHILD Please Select One Session Per Child. Only sessions that apply to your child’s grade group are displayed.
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Parent Information This field is hidden when viewing the form
Parent/Guardian*
First Name
Last Name
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Phone*
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Secondary Phone*
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Additional Parent/Guardian*
First Name
Last Name
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Phone*
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Secondary Phone (optional)
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Mailing Address*
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Email*
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Parent Authorization/Consent Forms This field is hidden when viewing the form
Activity & Trip Consent* I give permission for my child to participate in all phases of Camp Explore including off-campus field trips. Weekly field trips include but are not limited to: kayaking, paddle-boarding, hiking, overnight camping, climbing, swimming in pools and in the lake, backpacking as well as the transportation to and from those sites. By signing below I agree to the terms discussed above.
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If No, please explain which activities are exempt.
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Animal Interaction Permission* I understand that Camp Explore may offer animal encounters which include but are not limited to wildlife and domestic species such as, birds, butterflies, crawdads, fish, and dogs. Camp Explore takes every precaution to ensure the health and safety of our participants during animal encounters. Species are vaccinated (contingent upon requirements according to the designated animal), and our pets are continually held to ensure trust and to build relationships. I understand by signing this form that Camp Explore is not liable financially or in any other way for any incident that may occur with the animals, including but not limited to damaged property, injury or illness.
I also understand that by signing this form I agree to allow my child to interact with the different species that may be part of the program.
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Expectations & Dismissal* I have informed the Camp Director and other appropriate Camp Explore staff of any limitations to my child’s participation and agree to abide by Camp Explore’s sole judgement as to whether my child can be accommodated in the camp program. I understand that failing to disclose any physical, emotional, or behavioral needs or conditions may result in the child’s dismissal from the program without refund. I understand that my child must follow the program’s behavior expectations and safety rules and that Camp Explore reserves the right in its sole judgement to dismiss without refund any child whose behavior interferes with the rights and safety of others.
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Behavior Management Policy* Camp Explore implements a Behavior Management Policy for managing unacceptable behaviors through the following steps: Reasoning, Loss of Privilege, Reflection Slip, Parent Conference, and if the unacceptable behavior persists the child may lose full activity privileges or may be suspended from the program without a refund. I understand and accept the program’s Behavior Management Policy.
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Transportation Safety & Emergency Procedures* I understand that campers & staff will be transported by bus by trained staff and/or in private vehicles (also by trained staff) in the event of an emergency. I give permission to Camp Explore staff to transport my child during the course of the Camp Explore programs.
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Sunscreen & Bug Repellent* I understand that outdoor exploration is an integral part of Camp Explore programs and my child will be exposed to risks including but not limited to sun and insects. I give permission to Camp Explore staff to assist my child in re-applying sunscreen, insect repellent, and topical anti-itch cream.
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Photo/Video Release* By signing below, I give permission for my child to be photographed and pictures released for publication. I release all claims against Tahoe Family Solutions with respect to copyright ownership and publication including any claim for compensation related to use of the materials. When images are published, the camp will take cautionary steps to provide minimum identifying information.
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Medical Release Form & Insurance Information The purpose of acquiring this information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. If not applicable then leave blank.
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Health Insurance Provider
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Policy Number
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Primary Physician
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Physician Address
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Physician Phone
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Hospital Preference
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Preexisting Medical* Does the child have any allergies, injuries, medical conditions, special needs, or behavioral/emotional issues. Is the child taking any medications?
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Please explain and list all conditions and medications.
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Should a paramedic be called if their condition becomes an issue? This field is hidden when viewing the form
Does your child require a special diet?* This field is hidden when viewing the form
If Yes, please explain
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Medical Emergencies* I understand that I will be notified in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize my child to be taken to the nearest medical facility for appropriate treatment.
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Pay & Register This field is hidden when viewing the form
READ CAREFULLY BEFORE SIGNING:* I have read and understand the information presented in this registration form. I am are aware and understand that the activities included during the Camp Explore program involve inherent risks and may result in personal injury or death. I accept all camp procedures and regulations. I am fully informed about the risks associated with participation in the activities and consent to my child’s participation in the Camp Explore program. I hereby do release TFS from any and all liability for any damage or injury that the participant may suffer due to participation in any activity provided during Camp Explore. TFS personnel will attempt to contact a parent or guardian, if possible, prior to transporting the minor to a physician or medical facility for emergency medical treatment. The undersigned grants permission to any licensed physician and/or medical facility to render emergency care to said participant and consents to such treatment. TFS will not be held responsible for any payments due for rendered care.
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Support the TFS Camp Explore program Will you consider a donation to Camp Explore of any amount to help support our work?
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Payment Options* If you are unable to pay in full now, please contact our Camp Director. We can accept a deposit to reserve your spot, and even set up a payment plan if needed. If you choose to defer payment, and would like to reserve your child’s spot with a deposit, please call us as soon as possible. A minimum of $50 is required to reserve a session for your child.
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How would you like to pay? *Note: If paying by check or cash, your slot will not be reserved until payment has been submitted.
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You have selected Cash payment Option
Please visit our office to make Cash payment at 774 Mays Blvd. #13 Incline Village, NV 89451. ** Note: your slot will not reserved until payment has been submitted.
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You have selected Check payment Option
Please make Check payment to Tahoe Family Solution. Please mail or stop by our office at 774 Mays Blvd. #13 Incline Village, NV 89451. ** Note: your slot will not reserved until payment has been submitted.
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Number
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Number
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