Capital Ultimate Camp Registration 2018
We are looking forward to another great year of Ultimate Frisbee Camps. Please register your camper by filling out the form below.
Camper Age *
As of July 2018
Grade camper will be in 2018 - 2019 *
Camper Gender *
Camper Last Name *
Your answer
Camper First Name *
Your answer
Which Sessions Attending
Use the next 7 questions to let us know which sessions your camper is planning to attend this summer
High School Evenings
Washington Lee High School, July 9 - 13. 4pm - 7pm. ($150), Ages 14 - 18
Elementary School Mornings
Washington Lee High School, July 9 - 13. 9am - noon ($150), Ages 9-11
Middle School 1
Swanson Middle School , July 16 - 20 ($300), Ages 11 - 14
Middle School 2
Swanson Middle School, July 23 - 27 ($300), Ages 11 - 14
Bayside
Overnight Sleep Away, St. Margarett's School (Tappahanock VA), August 11 - 15 ($500), Ages 14 - 18
Total Number of Sessions *
This summer how many is this youth attending
Your answer
Extended Day? *
Required
Including this summer, how many summers have you attended CUC? *
Not sessions but summers
What Adult Size Shirt/Shorts does the camper want their 'gear' to be? *
*If registering for Elementary Camp, What children's size...?
School camper will attend in 2018 - 2019 *
Your answer
Street Address *
Example 4100 Vacation Lane, Arlington VA 22207
Your answer
Parent 1 Name *
Your answer
Parent 1 Email *
Your answer
Parent 1 Phone Number *
Your answer
Parent 2 Name
Your answer
Parent 2 Email
Your answer
Parent 2 Phone Number
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency/Medical/Allergy Information
Your answer
Other Information?
Your answer
How did you find out about us
For Emergency purposes, please provide your doctors information. *
Doctor's Name, Address, and Phone Number
Your answer
How do you plan to submit payment? *
Just so we know where to look, if you change your mind it's not a big deal.
Liability *
1. I will comply with the stated & customary terms & conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation & bring such to the attention of the nearest official immediately. 2. I acknowledge & fully understand that each participant will be engaging in activities that involve risk of serious injury including traumatic brain injury, permanent disability & death, & severe social & economic losses which may result not only from their own actions, inactions or negligence but the action, inaction or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, I accept personal responsibility for the damages following such injury including traumatic brain injury, permanent disability or death. 3. I hereby authorize & give my full consent to Capital Ultimate Camp, in perpetuity, to copyright &/or publish any & all photographs, video &/or broadcasts in which I appear while attending any Capital Ultimate Camp event. I further agree that Capital Ultimate Camp may transfer, use or cause to be used, photographs, video, or broadcasts for any exhibitions, public displays, publications, commercials, online streaming, art & advertising purposes, & television programs without limitations or reservations, in perpetuity. 4. I knowingly & freely assume all such risk, both known & unknown, even those arising from the negligent acts or omissions of others & assume full responsibility for my participation. 5. I, for myself & on behalf of my heirs, assigns, personal representatives & next of kin, hereby release, & agree to hold harmless Capital Ultimate Camp, its officers, officials, affiliated clubs, their respective administrators, directors, agents, coaches, & other employees of the organization, other participants, sponsoring agencies, advertisers, &, if applicable owners & lessors of premises used to conduct the event, all of which are hereinafter referred to as “releasees”, with respect to all & any injury, disability, death or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law. I will indemnify, save & hold harmless above named releasees of, from & against any loss, cost, expense, damage or liability that such releasees may incur as a result of, arising from or in connection with such claim, including without limitation any attorney's fees, or other costs or expenses or litigation. 6. I agree that, as a Capital Ultimate Camp member, player, organizer or representative of the organization, I will not compete at Capital Ultimate Camp official, sponsored, sanctioned or affiliated events, or carry out responsibilities related to official organization & event business, while under the influence of alcohol or illegal/banned drugs. Additionally, I will not engage in any unlawful acts at such events, including but not limited to the unlawful or unauthorized use, possession, distribution or consumption of alcoholic beverages or illegal/banned drugs at said events or while representing Capital Ultimate Camp in an official capacity. 7. I will comply with and be bound by the stated and customary terms and conditions for participation.
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