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TRUE NORTH CLIMBING

CAMPER PROFILE

2022 Season

One form required per season per camper

Must be signed by a Parent or Legal Guardian


Injuries: Parents will be notified immediately by phone when a child experiences a serious injury (e.g. head or facial trauma, sprain, laceration, etc.). NOTE: there are at least 2 staff with First Aid and CPR training at True North at all times.

I Agree

 

Sunscreen Policy: We will have a communal spray bottle of sunscreen (Coppertone Sport Continuous Spray Sunscreen-SPF30) available for any outdoor activity we may have. Please teach your kids the importance and the proper application prior to camp. If you wish to bring your own sunscreen, please clearly label it with the child’s name. 

I Agree

 

Self sign in/out: Minors under the age of 13 must be supervised at all times in our facility. If you give your child permission to sign themselves in/out, they cannot remain inside the gym on their own, unless early drop off or extended care has been pre-arranged and paid for. 

I Agree

 

Participation in True North Climbing Day Camps requires adherence to the safety guidelines, policies and staff instruction at True North Climbing. Our staff will address minor disciplinary issues in house, including the use of brief “time outs,” but in cases of repeated behavioral or safety concerns, a parent will be contacted. If deemed necessary, your child may be temporarily suspended or fully removed from camp without a refund

I Agree


First Camper's Name

First Name*

Last Name*
First Camper's Date of Birth*
First Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
First Camper's Signature*
Second Camper's Name

First Name*

Last Name*
Second Camper's Date of Birth*
Second Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Third Camper's Name

First Name*

Last Name*
Third Camper's Date of Birth*
Third Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Fourth Camper's Name

First Name*

Last Name*
Fourth Camper's Date of Birth*
Fourth Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Fifth Camper's Name

First Name*

Last Name*
Fifth Camper's Date of Birth*
Fifth Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Sixth Camper's Name

First Name*

Last Name*
Sixth Camper's Date of Birth*
Sixth Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Seventh Camper's Name

First Name*

Last Name*
Seventh Camper's Date of Birth*
Seventh Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Eighth Camper's Name

First Name*

Last Name*
Eighth Camper's Date of Birth*
Eighth Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Ninth Camper's Name

First Name*

Last Name*
Ninth Camper's Date of Birth*
Ninth Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Tenth Camper's Name

First Name*

Last Name*
Tenth Camper's Date of Birth*
Tenth Camper's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Parent's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.

Only a minor's parent may sign for that 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.


Parent's Name

First Name*

Last Name*
Parent's Date of Birth*
Parent's Medical Information

Please list any special needs, medical conditions, medications, allergies or dietary restrictions you would like us to know about your child (leave blank if none).
Can your child sign in/out on their own?*
No
Yes

Other than yourself, who may pick up your child? Please provide full names (leave blank if none).
Parent'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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