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Teen Camp Registration 2022

indicates a required answer

1. *

How many Teens in your family are attending Teen Camp this year?

2. *

TEEN 1 - Registration information for first teen in family

Teen 1 Name

3. *

Teen 1 Gender

Male Female
4. *

Teen 1 Birthday (mm/dd/yyyy)

5. *

Teen 1 T-Shirt Size

6. *

Does Teen 1 have any known allergies (food or other) or medical problems? Please explain if yes. If there is medication they need, please put it in its original container with instructions.

7. *

Which, if any, of the following medications do you give permission for Teen 1 to take? (Hold down Command/Control to check all that apply)


Use your Ctrl & Shift keys to select multiples.
8. *

Are there any medications Teen 1 is sensitive to or has a problem with?

9. *

Does Teen 1 have any special needs?  If so, please explain.

10. 

TEEN 2 - Registration information for second teen in family

Teen 2 Name

11. 

Teen 2 Gender

12. 

Teen 2 Birthday (mm/dd/yyyy)

13. 

Teen 2 T-Shirt Size

14. 

Does Teen 2 have any known allergies (food or other) or medical problems? Please explain if yes. If there is medication they need, please put it in its original container with instructions.

15. 

Which, if any, of the following medications do you give permission for Teen 2 to take? (Hold down Command/Control to check all that apply)


Use your Ctrl & Shift keys to select multiples.
16. 

Are there any medications Teen 2 is sensitive to or has a problem with?

17. 

Does Teen 2 have any special needs?  If so, please explain.

18. 

TEEN 3 - Registration information for the third teen in family

Teen 3 Name

19. 

Teen 3 Gender

20. 

Teen 3 Birthday (mm/dd/yyyy)

21. 

Teen 3 T-Shirt Size

22. 

Does Teen 3 have any known allergies (food or other) or medical problems? Please explain if yes. If there is medication they need, please put it in its original container with instructions.

23. 

Which, if any, of the following medications do you give permission for Teen 3 to take? (Hold down Command/Control to check all that apply)


Use your Ctrl & Shift keys to select multiples.
24. 

Are there any medications Teen 3 is sensitive to or has a problem with?

25. 

Does Teen 3 have any special needs?  If so, please explain.

26. 

TEEN 4 - Registration information for fourth teen in family

Teen 4 Name

27. 

Teen 4 Gender

28. 

Teen 4 Birthday (mm/dd/yyyy)

29. 

Teen 4 T-Shirt Size

30. 

Does Teen 4 have any known allergies (food or other) or medical problems? Please explain if yes. If there is medication they need, please put it in its original container with instructions.

31. 

Which, if any, of the following medications do you give permission for Teen 4 to take? (Hold down Command/Control to check all that apply)


Use your Ctrl & Shift keys to select multiples.
32. 

Are there any medications Teen 4 is sensitive to or has a problem with?

33. 

Does Teen 4 have any special needs?  If so, please explain.

34. *

Parent / Adult Information:

Parent or Guardian First and Last Name

35. *

Phone Number(s) where parents can be reached during Teen Camp

36. *

E-mail address (Your invoice will be sent to this address)

37. *

Full Address

38. 

How many Adults in your family are attending Teen Camp this year?

39. 

Please list the names of all adults attending.

40. 

If you are an adult ordering one or more t-shirts for yourself or other adults, please list the size(s) you want. (The first t-shirt for each adult attendee is free, extras are $10 each.)

41. *

Name of Emergency Contact #1

42. *

Phone Number

43. *

Name of Emergency Contact #2

44. *

Phone Number

45. *

Medical Insurance Information

Insurance Company

46. *

Policy Holder Name

47. *

Policy Holder Date of Birth (mm/dd/yyyy)

48. *

Identification Number

49. *

Group Number

50. *

Insurance Customer Service Phone Number

 

Youth Behavior Agreement

ALL YOUTH ATTENDING MUST SIGN THE FOLLOWING FORM:

Coming to Teen Camp is a wonderful experience, but it requires that all campers be willing to abide by certain rules of SAFETY and BEHAVIOR in order for everyone to get along and have a great experience.

You are expected to obey all rules and standards of safety and good behavior in order to attend Deseret Teen camp.

1. There will be NO tolerance for swearing, crude or sexual discussions of ANY kind!!

2. You are not to ever to be in a cabin of the opposite sex. You are not to leave your cabin at night.

3. Youth should not pair up with members of the opposite sex at camp. Stay with the group at all times. If you are doing something apart from the group you need to be in a group of three people or more.

4. Electronics, phones, iPods etc... should be left at home. If having these possessions becomes a barrier between you and other campers or activities camp chaperones will take them from you. Remember, you come to camp to be with old friends and to make new friends.

5. Everyone is to dress modestly at all times at camp. You must cover up your modest swimsuit as soon as you leave the pool. All shirts should have sleeves, modest necklines, and completely cover the belly. Shorts should come almost to the knees. Boys should wear shirts at all times when not swimming.

6. Youth are expected to refrain from demonstrations of affection. That means there will be NO hand holding, kissing, romantic hugging, caressing, sitting on laps, hanging on each other or anything else that makes you appear to be a couple. No matter what your family’s standards may be at home, you are expected to follow these strict standards at camp.

7. Please remember that the parents at Teen Camp are the staff, without them there would be NO camp. With that in mind ALL adult leaders will be treated with respect and obeyed.

8. Team leaders and TLC members need to be treated with respect as well. They have sacrificed a lot of time and effort to put this camp together. Please participate when they ask you to do so.

9. Youth are expected to help the camp by picking up trash, helping their team with cleaning assignments, cleaning their cabins, and doing what is asked of them. Please be the type of youth who willingly serves, instead of leaving the work for others. If everyone helps, the job gets done quickly, leaving time for a lot of outside fun.

We love the youth at Teen Camp. You are the reason we make this camp possible! That being said, we are very serious about the rules and will not allow one or two in the group ruin the experience for others. Please remember that you will be held accountable for your behavior.

PARENTS: We are just simply not equipped to handle behavior problems at camp. So, please have all youth in your household sign below indicating that they understand the rules, and that they understand that if they disobey any of these rules, they will be asked to leave camp and receive no refunds. Parents will be responsible for making arrangements to have them picked up early if this occurs.

51. *

TEEN 1: I agree to abide by the rules of camp.

(By checking these, you indicate your agreement to follow the stated rules.)

 (16 required)
I have read the above listed camp rules. I know I'm expected to participate in activities.
I will treat others with respect. I will stay on the grounds.
I won't be alone with a member of the opposite sex Teens under 18 can't leave without permission.
I'll stay out of cabins of the opposite sex. I will be responsible for all of my belongings.
I'll abide by For the Strength of Youth standards. I'll always stay in groups of at least 3 people.
I won't wear tight, short or revealing clothing. I will not jeopardize others' health and safety.
I'll respectfully change my clothing if asked. I will not jeopardize my own health and safety.
I'll respectfully change my behavior if asked. If I don't follow these rules I can be sent home.
52. 

TEEN 2: I agree to abide by the rules of camp.

(By checking these, you indicate your agreement to follow the stated rules.)

 
I have read the above listed camp rules. I know I'm expected to participate in activities.
I will treat others with respect. I will stay on the grounds.
I won't be alone with a member of the opposite sex Teens under 18 can't leave without permission.
I'll stay out of cabins of the opposite sex. I will be responsible for all of my belongings.
I'll abide by For the Strength of Youth standards. I'll always stay in groups of at least 3 people.
I won't wear tight, short or revealing clothing. I will not jeopardize others' health and safety.
I'll respectfully change my clothing if asked. I will not jeopardize my own health and safety.
I'll respectfully change my behavior if asked. If I don't follow these rules I can be sent home.
53. 

TEEN 3: I agree to abide by the rules of camp.

(By checking these, you indicate your agreement to follow the stated rules.)

 
I have read the above listed camp rules. I know I'm expected to participate in activities.
I will treat others with respect. I will stay on the grounds.
I won't be alone with a member of the opposite sex Teens under 18 can't leave without permission.
I'll stay out of cabins of the opposite sex. I will be responsible for all of my belongings.
I'll abide by For the Strength of Youth standards. I'll always stay in groups of at least 3 people.
I won't wear tight, short or revealing clothing. I will not jeopardize others' health and safety.
I'll respectfully change my clothing if asked. I will not jeopardize my own health and safety.
I'll respectfully change my behavior if asked. If I don't follow these rules I can be sent home.
54. 

TEEN 4: I agree to abide by the rules of camp.

(By checking these, you indicate your agreement to follow the stated rules.)

 
I have read the above listed camp rules. I know I'm expected to participate in activities.
I will treat others with respect. I will stay on the grounds.
I won't be alone with a member of the opposite sex Teens under 18 can't leave without permission.
I'll stay out of cabins of the opposite sex. I will be responsible for all of my belongings.
I'll abide by For the Strength of Youth standards. I'll always stay in groups of at least 3 people.
I won't wear tight, short or revealing clothing. I will not jeopardize others' health and safety.
I'll respectfully change my clothing if asked. I will not jeopardize my own health and safety.
I'll respectfully change my behavior if asked. If I don't follow these rules I can be sent home.

 

HEALTH AND SAFETY

Deseret Homeschoolers will follow all safety guidelines to the best of our ability, but families are fully responsible for their own health and safety in avoiding COVID-19 or any other illness.

IN CONSIDERATION of being permitted to participate in any way in the activities of DESERET HOMESCHOOLERS OF SOUTHEAST TEXAS (“Activities”) I give permission for myself, for personal representatives, assigns, heirs, and next of kin and for the aforementioned Minor(s) as THE MINOR’S PARENTS AND/OR LEGAL GUARDIAN:

ACKNOWLEDGE, agree, and represent that I understand the nature of Activities and that I and/or the Minor(s) as the case may be, are qualified, in good health, and in proper physical condition to participate in such Activities. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activities and cause Minor(s) to do so as well.

I FULLY UNDERSTAND THAT: (a) ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUSBODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“RISKS”); (b) these Risks and dangers may be caused by my own actions or inaction’s, the actions or inaction’s of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE “RELEASEES” NAMED BELOW; © there may be OTHER RISKAND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITYFOR LOSSES, COSTS, AND DAMAGES I or the Minor(s) incur as a result of my or their participation in the Activities.
I HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE DESERET HS, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, and the owner and lessors of premises on which the Activities take place FROM ANY AND ALL LIABILITY FOR INJURY, INCLUDING DEATH, LOSS OR DAMAGE TO PERSON OR PROPERTY, ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND I FURTHER AGREE that if, despite this PARENTAL PERMISSION, LIABILITY & MEDICAL RELEASE, I, or anyone on my behalf or on behalf of the Minor(s), makes a claim against any of the Releases, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim.

I FURTHER CONSENT TO ALL EMERGENCY MEDICAL TREATMENT as may be deemed appropriate under existing circumstances by Deseret HS officers and volunteers or medical personnel.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY ANDWITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

THIS DOCUMENT SHALL BE EXECUTED BY THE PARENTS OR LEGAL GUARDIANS OF ANY MINOR.

 

Teen Camp Fees:

Teens: $215 each

Adults: $70 each

 

 

55. *

Signature

56. *

Date

57. 

For Administrative Purposes:

58. 

For Administrative Purposes: