Sky Ranch Participation Form

Register Here

Camper Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Age*
Please enter a number from 3 to 18.
Gender*
- Female
- Male
Address*
Street Address Address Line 2 City State ZIP Code
Grade Completed
(as of June 1st)
Parent or Guardian Information
Parent/Guardian Name*
First Last
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell/Other*
Emergency Contact Information
Emergency Contact*
First Last
Relationship*
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Cell/Other Phone*
Persons Authorized to Transport Child*
- Either Parent
- Mother Only
- Father Only
- Pastor/Youth Director
Release
I hereby release Sky Ranch Lutheran Camp, its agents, members, and employees, from all liability for any accident, injury or claim arising from the camper named above's use of any of it's facilities, or participation in any of it's programs.

In case of emergency, I understand every effort will be made to contact me and the authorized persons named above. I understand our congregational contact will handle primary medical response. In the event we cannot be reached, I give my permission to camp officials to provide for the camper named above any medical or surgical care. I understand that Lutheran Ranches of the Rockies (dba Sky Ranch Lutheran Camp) does not carry health/accident insurance on its campers and I will accept the expense of emergency medical or surgical treatment through personal insurance or personal resources.

Sky Ranch Lutheran Camp may use, for promotional purposes, any photographs & video taken of the camper named above.
Supervised trips*
- I give permission for the camper named above to go on Sky ranch Lutheran Camp staff supervised trips away from camp premises, whether on foot, on horse or by vehicle.
High Ropes Challenge Course*
- I give permission for the camper named above to participate in all appropriate elements of the High Ropes challenge course. I understand that campers who have completed grade six and older can participate in high challenge elements, but that low challenge activities are available with age appropriate activities for all ages.
General Release*
- I give permission for the camper named above to participate in all camp activities with the following exceptions:
Activities my child cannot participate in
Signature*
Email
This field is for validation purposes and should be left unchanged.

Sky Ranch Participation Form

Register Here

Parent or Guardian Information

Emergency Contact Information

Release

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