Registration

The cost of the camp is $30.00 per camper. Guardian consent is also required. Instructions for submitting payment and guardian consent will be emailed to you after you submit the registration form. No payment is required to submit the form. Registration submissions recieved without payment do not guarantee a spot will be held for your child.

All participants should be registered before June 20, 2017. Late registration will be accepted only as space permits.


Online Registration

Camper Information

Camper Medical Information

Medical History:

Current Medications:

Medication Allergies:

Emergency Contact Information

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Parent Information

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Additional Information

Special Needs or Comments:

Verification

By submitting this form I verify that I am the parent/guardian of the child listed above, a minor child applying to participate in Junior Fire Camp, sponsored by the Vigo County Agencies of Emergency Response (VCAER). For my child and myself I acknowledge, agree and understand that:

  1. Voluntarily and of my own free will, I agree to allow my child to participate in the Junior Fire Camp. I understand the deadline for applications is June 20, 2017 and the fee for the camp is $30.00. I understand that registration is not confirmed until the camp fee and the Parent Signature Form (information emailed upon registration) are recieved by the Junior Fire Camp staff.
  2. I understand that the participant may be involved in certain physical activities and there are certain potential risks and hazards involved in participation in Junior Fire Camp that could result in stress, injury or death to participant(s), including, but not limited to those hazards associated with natural conditions, equipment, staff and other participant’s actions.
  3. I hereby approve my child’s participation in all aspects of Junior Fire Camp.
  4. I understand that I will need to provide daily transportation for my child to and from the camp site.
  5. To the best of my knowledge, there are no physical or other conditions which would restrict my child’s participation in Junior Fire Camp. I further consent to any emergency medical treatment for my child deemed to be required by medical professionals, and will remain responsible for all costs incurred for such care.
  6. I voluntarily elect to accept and assume all risk of injury incurred or suffered by my child while participating in Junior Fire Camp, including all activities related thereto.
  7. I release, discharge and agree not to hold liable the Vigo County Agencies of Emergency Response (VCAER), and/or any of these agencies departments, officers, members, employees, or any person or entity connected with these agencies for any claim, damages, costs, or cause of action which my child or I may now, or in the future, have as a result of injuries or damages sustained or incurred by my child from whatever cause including but not limited to the negligence, breach of contract or wrongful conduct of the parties hereby released, and shall indemnify and hold harmless the Vigo County Agencies of Emergency Response (VCAER) and/or any of these agencies departments, officers, members, employees, or any person or entity connected with these agencies for any and all claims or damages of any kind what so ever which may result from the activities for which my permission has been given.
  8. I understand that any information, including medical information, provided on this form will be kept private and only shared with the Vigo County Junior Fire Camp Staff as needed except, under circumstances where my child requires medical attention, the information provided will be shared with health care workers providing direct care to my child.

By checking this box I acknowledge that I have read and agree to the above statements.

Camp Sponsors

Participating Agencies

Special Thanks


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