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*Pre-camp forms MUST be submitted the Monday before your camper's registered session to ensure participation.*


PLEASE READ COMPLETELY AND CAREFULLY BEFORE SIGNING

ASSUMPTION OF RISK AND RELEASE OF LIABILITY

Camp Habitat is a non-profit, non-commercial enterprise that is part of Friends of Creamer’s Field. Camp Habitat has taken reasonable precautions to provide a safe day camp environment. However, as with any outdoor physical activity, injury is a possibility and a concern. Therefore, the parents or legal guardians of a minor participant must understand and agree that they assume the risk of injury when they, their son, daughter, or minor in their care participate in Camp Habitat activities. The participant's parents or guardians specifically agree to release Camp Habitat and Friends of Creamer’s Field from any liability arising from any injury or loss to the participant. Furthermore, the participant and the participant's parents or guardians agree to hold Camp Habitat and Friends of Creamer’s Field harmless from any claims arising from the participant's participation in Camp Habitat activities.

I understand that to participate in this program, my child(ren) must abide by the established rules and codes of conduct established by the program staff. Camp Habitat reserves the right to dismiss a child from the Camp due to that child's disruption of the program, including but not limited to verbal and physical aggression against staff or other participants, failure to follow safety or program instructions, and any other disruptive behavior. A child's dismissal will be at the discretion of the Camp Director. If a child is dismissed from camp, there will be no refund.

Having read and understood the terms and conditions of this agreement, the undersigned do hereby agree to abide by them.

Parent's or Guardian's Agreement for participants under the age 18 years:

We will abide by all of the terms in this agreement.


Today's Date: June 6, 2025


MEDICAL RELEASE AUTHORIZATION 

In the event an accident or illness befalls my child, first aid will be administered, and my child’s emergency contact numbers will be called. If my child’s contacts cannot be reached and he/she requires emergency care by a physician, I authorize Camp Habitat to treat my child on an emergency basis.  

I have read the above form and agree to its terms as noted.  


Today's Date: June 6, 2025


MEDIA RELEASE OF LIABILITY 

Camp Habitat and Friends of Creamer’s Field are not responsible for photographs and videos taken by other campers, parents, or the general public. I release Camp Habitat and Friends of Creamer’s Field and respective employees, staff, and volunteers of each, from any and all liabilities or damages incurred in connection with the use of my son/daughter’s picture by an unsolicited source. I have read the above form, agree to its terms as noted, and have provided accurate information as requested to the best of my ability for my camper. 

I have read the above form and agree to its terms as noted. 


Today's Date: June 6, 2025

First Participant's Name
First Name*
Last Name*
First Participant's Date of Birth*
Date of Birth
First Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Media Release

I authorize Camp Habitat and Friends of Creamer’s Field to use any photographs or videos taken for publicity purposes to highlight Camp Habitat Summer Camps through advertising: social media, the newspaper, newsletters, websites, grant applications, posters, brochures, displays, and Friends of Creamer’s Field /Northern Alaska Environmental Center/Alaska Department of Fish & Game publications. 

I agree with the noted terms of the media release.
I do not want pictures of my child used for publicity.
Camper Contact #1

PLEASE READ COMPLETELY AND CAREFULLY

Information and updates regarding Camp Habitat will be sent to the email used to register the camper in Brushfire as well as the contacts (#1 and #2) provided in this form. The email address listed at the end of this form will not be contacted and is only used to retain a copy of this signed form. 

When Camp Habitat needs to communicate urgently, the listed contacts (#1 and #2) will be contacted first. We assume these contacts will be reachable and accountable during the camper's registered week. This includes but is not limited to, medical or behavioral emergencies, weather closures, and pick-up/drop-off information. The listed contacts (#1 and #2) can be a duplicate of the person who registered the camper, as long as they are reachable and accountable for the camper during their registered week.

Contact #1 and #2 will be authorized to check campers in/out of camp with a valid ID


Contact #1 First and Last Name *
Contact #1 Phone Number *
Contact #1 Email Address
Contact #1 Relation to Participant*
Camper Contact #2

PLEASE READ COMPLETELY AND CAREFULLY:

Information and updates regarding Camp Habitat will be sent to the email used to register the camper in Brushfire as well as the contacts (#1 and #2) provided in this form. The email address listed at the end of this form will not be contacted and is only used to retain a copy of this signed form. 

When Camp Habitat needs to communicate urgently, the listed contacts (#1 and #2) will be contacted first. We assume these contacts will be reachable and accountable during the camper's registered week. This includes but is not limited to, medical or behavioral emergencies, weather closures, and pick-up/drop-off information. The listed contacts (#1 and #2) can be a duplicate of the person who registered the camper, as long as they are reachable and accountable for the camper during their registered week.

Contact #1 and #2 will be authorized to check campers in/out of camp with a valid ID

Contact #2 First and Last Name *
Contact #2 Phone Number *
Contact #2 Email Address
Contact #2 Relation to Participant*
Parent or Guardian's Email Address
Email*
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Relationship*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
1. Camp Session *
2. Age group *

Medical History


Name of Physician/Clinic:

Please describe any medical conditions that the participant has or has had in the past: Allergies to food, medication, or insect bites:

Current Medications:

Medical Concerns (chronic illness, asthma, diabetes, surgery, dietary restrictions, etc.):

Special Needs? We want to provide every camper with the best possible experience. Please inform us if your child has special needs and how we can best accommodate them.
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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