White Eagle Youth Camp – Registration

Parent or Guardian Information

First Name *

Last Name *

Emergency Contact Number *

Email Address *

Camp Attendee Information

First Name *

Last Name *

Birthdate *

Age

Request Approval

Because this camper will be over the age of 20 at camp, please provide a reason we should allow an exception.

Request Approval

Because this camper will be under the age of 13 at camp, please provide a reason we should allow an exception.

Complete Registration and Submit

Camp Participation Agreement

I hereby authorize the staff of the White Eagle Youth Camp to act for me according to their best judgement in any emergency requiring medical attention and I hereby waive and release WMO from any liability for any injuries or illnesses incurred while attending camp.  I have no knowledge of any physical impairment that would be effected by the above camper’s participation in activities at White Eagle Youth Camp and I authorize participation in all camp activities, including water sports.  I will be responsible for any medical charges in connections with his or her attendance at camp.  I also understand that White Eagle Youth Camp retains any right to use photographs of campers taken while at camp.  I have read and agree to the White Eagle Youth Camp Rules and Guildelines and the Camp Participation Agreement in its entirety and I give permission for those listed above to attend camp and participate in activities.

Do you accept the above agreement? *

I accept the agreement

I do NOT accept the agreement

If you are human, leave this field blank.