Camp TRI:21 Family Application 2020
Please fill out all questions as completely as possible. If a question does not apply to you and requires an answer, please write NA (not applicable). Once your application has been received, we will notify you if accepted. Once accepted, DSACC will send you electronic files of all final paperwork needed.
Email address *
Why would you like to attend DSACC Camp TRI:21 Family Camp? (i.e. what would your family get out of a trip like this) *
Your answer
Transportation Preference. *
Parent Contact *
Your answer
Parent 1 address *
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Parent 1 mobile phone number *
Your answer
Parent 1 email *
Your answer
Parent 2 Name *
Your answer
Parent 2 mobile phone number
Your answer
Parent 2 email
Your answer
Child with Down syndrome Name *
Your answer
Gender
Child w Ds Date of Birth *
MM
/
DD
/
YYYY
Sibling 1 Name *
Your answer
Gender
Sibling 1 Date of birth
MM
/
DD
/
YYYY
Sibling 2 Name
Your answer
Gender
Sibling 2 Date of birth
MM
/
DD
/
YYYY
Sibling 3 Name
Your answer
Gender
Sibling 3 Date of Birth
MM
/
DD
/
YYYY
Sibling 4 Name
Your answer
Gender
Sibling 4 Date of birth
MM
/
DD
/
YYYY
Please list names, date of birth and shirt shirt sizes of any other siblings joining group
Your answer
Please rate activities your family might be interested in participating in while at camp. Please note we will try to get every family the activities of their choice but some activities fill up quickly.
Count us in!
Meh
NO WAY!
Zip Line & Rock wall
Nature Hike
Talent Show
Ropes Course
Crafts & Tie dye
Parents only time
Bocce Ball
Campfire
Free time
other
Liability , Event & Photo Waiver: In consideration of your acceptance of my participation and as a representative of my family, intending to be legally bond do hereby my heirs, executor and administrators, waive and release forever any and all rights to claims for damages I may have against the Down Syndrome Association of Central California, Camp Arroyo, The Taylor Foundation and any other participating vendors, with this event. I attest to being physically fit to participate and have full knowledge of the risk involved in participation. I also give my permission for the free use of my name(s), photo, video, and or voice in any broadcast, telecast, print account or any other account in any medium of this event. I understand Camp takes place rain or shine. I understand that I am relinquishing substantial rights, including the right to sue, and I intend this agreement and waiver to be an unconditional release of all liability to the greatest extent permitted by law. *
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