Registration for Summer Camp 2023

Summer Camp Registration 2023

Have you already registered another camper with the same address, guardians, emergency contacts, and other information? *

Camper's Full Name *

First, Middle, and Last

Gender *

Male
Female

Birthdate *

Age (while at camp) *

Grade (Fall) *

Cabin Mate Request

(You may request only one friend. Your friend must also request you.)

Choose a Camp Week *

Pioneer Camp (Ages 14-18) June 4-9
Explorers #1 Camp (Ages 11-13) June 11-16
Discovery Camp #1 (Ages 8-10) June 18-23
Explorers Camp #2 (Ages 11-13) June 25-30 (There is only room for one more boy in this week. Any registrations after that will be placed on a waiting list.)
Day Camp (Ages 6-9) July 3-7
Discovery Camp #2 (Ages 8-10) July 9-14

(Ages while at camp.)

________________________________________________________

Camp Fees

Reservation fee due with Registration, Remainder due by sign-in. You will be given the option to pay your registration online after you submit this form. Optionally, the reservation fee can be mailed to: Camp Ozone, 232 Camp Ozone Rd. Rockwood, TN 37854 Checks should be addressed to "Camp Ozone" Please put the camper's name in the memo area.

Overnight Camp - $250 total camp fee. $50 non-refundable deposit due with registration, remainder of $200 due by Check-in. Camp fees cover lodging, meals, activities, T-shirt, and a craft. Day Camp – $150 total camp fee. $50 non-refundable registration fee due with registration, remainder of $100 due by Check-in. Camp fees cover lunch, snack, activities and a craft

Please choose your preference for camp fee payment

Would you like to add money for your child's snack shack at this time?

Would your child be interested in participating in airsoft as an additional activity for a $15 additional fee? (Ages 12-18 only. All children will be required to wear face protection and follow safety rules.)

We are exploring the possibility of a horsemanship elective at Wildwood Stables this summer. There would be an additional fee for this activity. If we are able to proceed with this activity, and it is available during your camper's week, would you like to receive more information about it?

Would you like to purchase a souvenir package for your camper at this time?

Registration is not complete without a $50 Reservation fee. Space is limited. Reservations will be made on a first-come, first- served basis.

_______________________________________________________

Camper Release (Photo ID Required for pick up)

Please list Parents/Guardians and emergency contacts. In the event of an emergency, we will contact adults in the order listed below. This will also act as a list of those people authorized to pick up your child from camp.

_______________________________________________________

Medical Information

Any known health or behavioral concerns?

Other Information (anything else you would like us to know about your child’s behavior or physical, emotional, or mental health including activity restrictions.):

Any Drug Allergies?

Food Allergies/ Restrictions? (If food modifications are significant, please contact us to make prior arrangements. You may be asked to provide easy-to-prepare substitutions.)

Other Allergies?

Insurance Company

Policy Number

Primary Care Physician

Phone Number

(Our insurance will not cover any pre-existing conditions. In case of accident or injury, your insurance will be considered primary. Camp Ozone insurance will be submitted as secondary.)

________________________________________________________

Bring Medication and completed Medication form (from confirmation packet) in a gallon-sized storage bag to check-in. You must bring current medication in its container with instructions.

________________________________________________________

Release and Waivers

Release and Waiver: The information given above is correct and complete as far as I know. I understand that there are risks of physical injury involved in camp activities, and I agree to accept the full risk as a part of my child’s participation. I further agree to indemnify, hold harmless, and defend Camp Ozone, its board members, executive officers, staff, and employees from any and all claims for injuries, damages, or loss sustained by me or my child arising out of, connected with, or in any way associated with Camp Ozone.

Emergency Authorization: I hereby give permission to the first aid personnel selected by the camp director to provide standard first aid care, administer over-the-counter medication, seek emergency medical treatment, and arrange related necessary transportation. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp personnel to order x-rays, routine tests, hospitalize, secure proper treatment for and to order injection and/or surgery for my child as named above. I agree to the release of medical records necessary for treatment, referral, billing, or insurance purposes.

Promotional Release: I hereby give permission for the use of photos/videos in which my child may appear to be used for any promotional materials.

By making application: - I agree to have all my child’s medication turned in to the camp nurse at registration. - I give my child permission to participate in the entire camp program unless otherwise noted. - I understand that if my child misbehaves or brings unacceptable items he/she will be sent home without a refund. - I assure that my child will not bring a cell phone and will abide by the dress code sent with the confirmation.

I have read and agree to all of the Waivers and Releases listed above.

I would like to receive Camp Ozone e-mail newsletters and updates

A confirmation packet will be sent to acknowledge your child’s reservation.

Name