Camp IO Registration (CIT)

Please fill out the registration form below. Fields with an asterisk (*) are required.

Why do you want to be a CIT?

What qualifications do you have that would make you a good CIT?

Parent/Guardian 1

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Mobile Phone

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Home Phone

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Parent/Guardian 2

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Mobile Phone

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Home Phone

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Address

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Child 1

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Child 1 Birth Date

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Does Child 1 have any health concerns?

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Please list health concerns for Child 1.

Does Child 1 have a 504 or IEP plan?

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Please list diagnosis for Child 1

Child 2

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Child 2 Birth Date

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Does Child 2 have any health concerns?

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Please list health concerns for Child 2.

Does Child 2 have a 504 or IEP plan?

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Please list diagnosis for Child 2

No Child 2, please click Next.

Child 3

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Child 3 Birth Date

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Does Child 3 have any health concerns?

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Please list health concerns for Child 3.

Does Child 3 have a 504 or IEP plan?

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Please list diagnosis for Child 3

No Child 3, please click Next.

Child 4

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Child 4 Birth Date

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Does Child 4 have any health concerns?

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Please list health concerns for Child 4.

Does Child 4 have a 504 or IEP plan?

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Please list diagnosis for Child 4

No Child 4, please click Next.

Emergency Contact Name

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Emergency Contact Mobile Phone

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Emergency Contact Phone (Other)

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Authorized Person to Pick-Up Camper(s)

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Authorized Person Mobile Phone

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Authorized Person Phone (Other)

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If Other, please specify.

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Photo/Video Release

Camp IO/IO Workshop - Mélong Ling may include my child(ren) in photos and/or videos for daily blogs/newsletters and/or promotional purposes.

Check one below

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Participation Agreement

I hereby give permission for my child to participate in Camp IO. While all reasonable precautions will be taken to ensure my child’s safety and to prevent any injuries from occurring, I will not hold the staff liable for any accident, which may occur. My child and I understand that if, after one warning, any child is unable to maintain appropriate behavior at camp, that child will not be allowed to attend the remaining camp sessions scheduled for that week. I understand that parents will be notified at the time of the warning and before a child is removed from camp activities. Refunds will not be issued for any child so removed.

Participation Agreement

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Refund Policy

All payments are non-refundable. You will receive credit, based on the amount paid. Credits may be applied toward classes, camp, workshops, gatherings, and events. Credits do not expire.

Refund Policy

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Child 1 Camp Weeks

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Child 2 Camp Weeks

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Child 3 Camp Weeks

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Child 4 Camp Weeks

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