Scrubs Camp
Day/Time: June 5, 2024 8:00am - 4:00 pm
Location: ENMU-Roswell Health Science Building
Non Refundable Fee: $15.00 Due by May 10th by 12:00p.m.

Please fill out the following questions and then call 575-624-7125 TO PAY!!
You will not be able to participate without payment!!!!
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Email *
Full Name of Participant *
Date of Birth *
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Grade Level *
Address *
Emergency Name and Relation to Participant  *
Emergency Number *
Any allergies? Dietary Restrictions? and what? *
t-shirt size *
By signing below, I waive any risks of harm or injury which might occur to the participant due to my participation in the event or activity. I hereby release and forever discharge Eastern New Mexico University, sponsors, its employees, agents, officers, trustees, and, representatives from all liability, costs, and damages that might arise from participation in the ENMU-R Healthcare Careers Scrub Camp. I provide my consent for Eastern New Mexico University to seek emergency treatment if necessary. I agree to accept financial responsibility for the cost related to this emergency treatment. Participants involved in this camp activity may be interested in visually graphic activities that simulate the medical environment including anatomy and physiology.

I, the parent or guardian of the minor participant undersigned, do hereby release all rights or claims in connection with the photo(s)/videotape in which the minor participant appears, for use by Eastern New Mexico University-Roswell. If used, I understand that the photo(s)/videotape will be for the promotional purpose of assisting Eastern New Mexico University – Roswell, and my minor participant waives any right to inspect or approve the finished photos/or advertising copy. All photographs, digital files, and videotapes shall constitute the sole property of Eastern New Mexico University - Roswell.

I agree to abide by the rules, guidelines, verbal/ instructions, policies, and procedures of the Scrubs Camp staff and Eastern New Mexico University Roswell. understand that if I do not follow the rules and procedures. I will be dismissed from camp, without a refund for any fees paid.
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Participant Signature
I am the Legal Guardian/Parent for:
*

I hereby give my permission for him/her to take part in Scrubs Camp.
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Parents Signature
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