Junior Historian Camps @ Monroe County History Center
Junior Historian Summer Camps take place at the Monroe County History Center which is located at 202 E. 6th Street in Bloomington, Indiana. Each week of camp, the camp session begins at 9:00am and ends at 3:00pm. Please visit www.monroehistory.org for camp descriptions. No exceptions to camp age restrictions or registration deadlines.
Camp Registration
Camper Registration
Camp Choice
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Are you a member of the Monroe County Historical Society/Monroe County History Center?
Camper Name
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Date of Birth
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Age
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Sex
Street Address
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City
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State
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Zip Code
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Phone
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Parent/Guardian #1 Name
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Parent/Guardian #1 Phone
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Parent/Guardian #1 Email
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Parent/Guardian #2 Name
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Parent/Guardian #2 Phone
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Parent/Guardian #2 Email
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Camper T-Shirt Size
Alternate Emergency Contact Name
To be contacted if MCHC is unable to reach parents
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Alternate Emergency Contact Phone
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Release Forms
No personal information provided will be shared outside the necessary MCHS/MCHC staff, except medical information which will only be shared with appropriate medical personnel in the event of a medical emergency.
Field Trip and Participation Release
I give permission for my child (above named camper) to participate in the Junior Historian Program (JHP) activities and to go on field trips scheduled as part of said program. I release the Monroe County Historical Society (MCHS/MCHC) and individuals (Staff, Board, Affiliates) from liability in case of accident during activities and field trips related to the MCHS/MCHC and JHP, as long as reasonable safety precautions have been taken. I also agree to indemnify the MCHS/MCHC and individuals (Staff, Board, Affiliates), and JHP for any loss, cost, or damage (including attorney's fees) arising out of any and all actions resulting from or caused by myself or my child's participation in the JHP. I recognize that because of the potentially dangerous nature of the activity, an injury may be sustained. I agree that I have read and understand this release.
Photo Release
I hereby authorize the Monroe County Historical Society (MCHS/MCHC) to use, or to reproduce, my image or that of my child(ren) listed below in any photograph or interview for any MCHS/MCHC purpose, including general publicity, magazines, newspapers, social media, video clips, website, or promotional materials that will help the MCHS/MCHC promote its mission of preservation and education. I hereby release all claims and hold harmless the MCHS/MCHC (including Staff, Board, Affiliates) from any liability resulting from such publication. I agree that I have read and understand this release.
Your answer
Medical Release
As the parent/legal guardian of the above named minor child, I authorize all medical treatment, x-ray, laboratory, anesthesia, and other medical and/or hospital procedures may be performed the attending physician and/or paramedics for my child and waive my rights to informed consent of treatment. I understand in such a case, that reasonable attempt would first be made to contact me, time and conditions permitting. I have read and understand this release. NOTE: A copy of the child's insurance card will be collected on the first day of camp.
Allergies, Medical/Behavioral Conditions, and/or Necessary Educational Accommodations or any additional information.
This information will not be shared.
Your answer
We or I (Parents/Guardians) have read and agree to all the conditions listed in this registration form. We/I understand that a completed registration form and payment must be submitted in order for our child(ren) to be registered for the Gayle Cook Junior Historian Camp Program at the Monroe County History Center. We/I attest that all the above listed information is accurate to the best of our knowledge.
Electronic Signature Agreement
By selecting the "I Accept" button, you are signing this camp registration electronically. You agree your electronic signature is the legal equivalent of your manual signature on this camp registration.
Payment

Indiana History Camp and Hoosier Art Camp are $150/participant.
Museum members receive 10% off each week.

Reservations are subject to availability. If reservation is cancelled 3 weeks or more before camp start date, a 75% refund will be issued. If reservation is cancelled less than 3 weeks in advance, a 25% refund will be issued. There is no refund for no-shows.

Three ways to pay:
1. Mail a check to this address: Monroe County History Center, ATTN: Camp, 202 E. 6th St., Bloomington, IN 47408

2. Visit the History Center and pay in person.

3. Click link (http://bit.ly/2hRJZ01) to pay camp registration fee via PayPal. A PayPal account is not required. Please write "Camp" and your camper's name in the "Description" blank. (e.g. Camp - Kaylee Anderson)
Note - A $4 convenience fee will be assessed for paying online. Campers who register online must pay $129 or $154, respectively, per camp week.

Contact the MCHC Education Manager (mchceducation@gmail.com or 812-332-2517x3) with questions regarding registering multiple children.

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