Howell Woods Fall Camp Registration

Please fill out the following registration form to sign your camper up for 2022 Fall Day Camp at Howell Woods!

Please note: if you wish to register siblings, you must sign up each camper individually.

CAMP DATES:

Monday, 10/31 - 9am - 4pm

AND/OR

Friday, 11/11 - 9am - 4pm

For more information or questions, please contact:

Ken Mitchell
Interim Director
919-209-2112
khmitchelljr@johnstoncc.edu

Parent / Guardian Information

Please fill out the below information for the main contact of parent/guardian.
Please fill out the below information for the participant you wish to register for the Fall Day Camp.

Terms for Release/Waiver Forms

Please read the information below thoroughly.  Share with your camper prior to the first day of camp.

I, in consideration of the acceptance of my son/daughter (“Participant”) by Howell Woods Environmental Learning Center (“Howell Woods”) into its summer camp program (“the Program”), hereby acknowledge and agree to the following: It is agreed that the Participant will abide by the rules and regulations of Howell Woods for the Program. If the Participant violates such rules and regulations, and/or if he/she does anything which puts the safety or welfare of the group or of himself/herself in jeopardy, Howell Woods may take disciplinary or other action against the Participant, including, but not limited to expulsion of the Participant from the Program and sending the Participant home at my (parent/guardian) expense. I recognize that Howell Woods is in no way liable or responsible for my son’s/daughter’s transportation to or from the Program. If I fail to provide transportation to or from the Program for the Participant, I authorize Howell Woods in its sole discretion to do so. I accept that there are no inherent dangers while driving or riding in a motor vehicle, and if an incident should occur which injures or causes death to my son/daughter while traveling to or from the Program, I fully understand and agree that Howell Woods is not liable. I must provide to Howell Woods in writing any limitations or restrictions upon the person(s) to whom and/or the conditions by which the Participant may be released or transported to or from the Program to persons other than the undersigned. Absent such written instructions, I authorize Howell Woods to release or transport the Participant as it deems appropriate in its sole discretion. I have disclosed in writing to Howell Woods any medical condition of the Participant which is relevant to his/her participation in the Program. I hereby give my consent for Howell Woods to have the Participant treated by a physician or other medical care provider in case of sickness, sudden illness or injury while participating in the Program. It is understood that Howell Woods and its staff do not provide medical insurance for such treatment, and that the cost thereof will be at my expense. If I have supplied physician information to Howell Woods, Howell Woods will reasonably attempt to contact such physician for the Participant. However, I understand and agree that Howell Woods may in its sole discretion determine that the nature of the sickness, illness or injury may require the use of different emergency or other medical personnel. I understand that Howell Woods is not an insurer of the Participant, and it assumes no liability for personal injuries or property damages to the Participant or to third parties arising out of the activities of the Participant. I understand that the Participant’s participation in the Program will involve physical activities which could pose danger and risk of injury. I fully assume all such risks inherent in the Program including, but not limited to, those described herein. I understand that photographs, videos or other likenesses of the Participant may be taken and may be provided to publishers, used on Howell Woods’ website or otherwise on the internet, broadcast on television, and radio or otherwise, used in demonstration or presentations, or otherwise published. I grant permission for the Participant’s picture, image or likeness to be taken and used for any such purpose. I hereby forever release, acquit, discharge and hold harmless Howell Woods, its officers, trustees, agents, employees, representatives, volunteers, successors and assigns for all manner of claims, demands and damages of every kind and nature whatsoever which the undersigned or the Participant may now or in the future have against Howell Woods, its officers, trustees, agents, employees, representatives, volunteers, successors and assigns on account of any personal injuries, physical or mental condition, known or unknown, to the person and/or the property of the Participant, and the treatment thereof, as a result of, or in any way growing out of the acts of Howell Woods, its officers, trustees, agents, employees, representatives, volunteers, successors and assigns for the operation of the Program, including but not limited to, their negligence or gross negligence, in rendering the services above described or in any way incidental thereto. This agreement is applicable to and binding upon the parent/guardian, Howell Woods, and their respective trustees, officers, employees, agents, heirs, personal representatives, successors and assigns.
In order to provide a pleasant environment and to ensure the safety of our campers and staff, disruptive, destructive and/or dangerous behavior by campers is not allowed. Such behavior will result in the camper being dismissed immediately from the camp. When a participant is dismissed from camp for unacceptable behavior there will be NO REFUND.
Please acknowledge and and relay the camp rules to your child before the first day of camp -Respect other participants, instructors, and equipment -Always listen to instructors and speakers, and show consideration for others -No profanity -Stay with the group. Never leave assigned activity areas without staff permission -No electronic devices. Please turn off cell phones during class/session - Smoking is not permitted at any time - Please dress comfortably and appropriately - Campers must wear their name tag at all times.