Summer 2021 Camp Explore REGISTRATION
Email *
Student's Name *
Student's Grade in Fall of 2021 *
Week 1 - June 14th - 18th
Clear selection
Week 2 - June 21st - June 25th
Clear selection
Week 3 - June 28th - July 2nd
Clear selection
Week 4 - July 5th - July 9th
Clear selection
Week 5 - July 12th - July 16th
Clear selection
Week 6 - July 19th - July 23rd
Clear selection
Week 7 - July 26th - 30th
Clear selection
Before & After Care Options
Parent's Name *
Parent's Email Address *
Parent's Contact Number *
Parent's Mailing Address *
Emergency Contacts - Name and Information *
Medical Information - allergies, medications, etc.
Camper's T- Shirt Size *
I, the parent or guardian of the Camp Explore camper listed about as "student" , a minor who will be participating in a residential or commuter, Camp Explore LLC summer program, as consideration for allowing "student" to participate in events which are held on or off the Owasso 7th grade center campus, access which may require "Student" to be transported by a motor vehicle arranged by the Director(s) of the Camp Explore LLC program or his/her designee, with the intent of binding myself, my spouse (if applicable), my heirs, legal representatives and anyone who at law or in equity may make any claim on behalf of me or Student, do hereby voluntarily and knowingly assume all risk and agree to release, indemnify, defend, and hold harmless, Camp Explore LLC, corporately and individually, and its officers, employees, agents and others who may act on behalf of Camp Explore LLC against all liabilities, claims, suits or demands for injuries to "Student", myself or any other person and/or property resulting from or growing out of Student's participation of the on or off-campus event, including transportation to and from the destination of the on or off-campus event and including any acts or omissions constituting negligence by Camp Explore LLC, officers, employees or agents or anyone acting on behalf of Camp Explore LLC. *
I, as the parent or guardian of the "student" listed above, hereby consent to the collection and use of my "student's"image, by photography or video recording. I acknowledge these may be used on the Camp Explore LLC website, in newsletters, and publications as well as distributed to members or on social media. I further acknowledge that my "student’s" image may be used by Camp Explore LLC to promote Camp Explore LLC in the future. I understand that no personal information, such as names, will be used in any publications or online mediums unless my express consent is given. *
Medical Treatment Release: I hereby certify that I am the Parent and/or Legal Guardian of "student" and minor listed above and foregoing matter and I, on behalf of said minor, do hereby release all liability and covenant not to sue and do hereby agree to hold harmless and indemnify Camp Explore LLC as set forth in the body of the RELEASE above, with the force and effect as if executed by me. Further, as parent and/or legal guardian of said minor, I hereby give consent and authorize Camp Explore LLC and its agents, representatives and employees to secure emergency medical treatment for said minor while he/she is in attendance at said program conducted by Camp Explore LLC. Further, I acknowledge that I am responsible for health insurance and payment of all medical costs for said minor while attending said program. *
Sign Here: I hereby certify that the information provided on this form is true and correct to the best of my knowledge and by attaching the signature I agree and understand that the typed electronic signature shall have the same legal effect as an original signature and is being accepted as my original signature pursuant to the Oklahoma Uniform Electronic Transactions Act, Title 12A Okla. Statutes Section 15-101, et seq. *
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