Payment Button
It's super easy to pay online! Once you have confirmed available space in the session that you desire, click below to make your fast and easy payment! Remember to save your invoice for tax purposes!
Cancellation Policy
I have found it necessary to come up with a policy regarding camp cancellations and refunds. It's pretty simple, I think. When you reserve a spot for your child and pay for it, then that spot becomes unavailable for another child to use. Be thoughtful in your choice. If you decide that Valley Camp is not for you and yours, then please give me adequate notice, so that your spot can be offered to others. Most camps require 30 days notice, I'm going to say two weeks.
Because I am more than fair and believe that our world spins in a finer fashion when we offer our best out into it, I will go out on a limb and say this. If you decide that Valley Camp is not a good fit for you, I will issue a refund for your un-used days minus a $50 'restocking' fee, should you request it.
I say it clearly throughout this website, but my mission is fun! It is not educational. If that's what you are after....look elsewhere! We do learn, but it's certainly through the backdoor.
Below you will find a standard camp policy form and medical waiver.
Please print and send to:
Ivey Patton
Valley Camp
1700 CR 205
Durango, Co 81301
It's super easy to pay online! Once you have confirmed available space in the session that you desire, click below to make your fast and easy payment! Remember to save your invoice for tax purposes!
Cancellation Policy
I have found it necessary to come up with a policy regarding camp cancellations and refunds. It's pretty simple, I think. When you reserve a spot for your child and pay for it, then that spot becomes unavailable for another child to use. Be thoughtful in your choice. If you decide that Valley Camp is not for you and yours, then please give me adequate notice, so that your spot can be offered to others. Most camps require 30 days notice, I'm going to say two weeks.
Because I am more than fair and believe that our world spins in a finer fashion when we offer our best out into it, I will go out on a limb and say this. If you decide that Valley Camp is not a good fit for you, I will issue a refund for your un-used days minus a $50 'restocking' fee, should you request it.
I say it clearly throughout this website, but my mission is fun! It is not educational. If that's what you are after....look elsewhere! We do learn, but it's certainly through the backdoor.
Below you will find a standard camp policy form and medical waiver.
Please print and send to:
Ivey Patton
Valley Camp
1700 CR 205
Durango, Co 81301
I, _________________________________________________________________, on behalf of my minor child,
____________________________________________________, any personal representatives, heirs, and next of
kin, hereby release Valley Camp, Ivey Patton, or any employees, from any liability of personal injury,
death, or property damage through my child’s participation in the Valley Camp Summer Camp Program
(“Camp”).
I am fully aware, understand and acknowledge that my child(ren) will be involved in physical activities, both outside and indoors, during the Camp, including but not limited to hiking on nature trails, playground activities, interaction with animals, theater activities, gardening, and arts and crafts that my child will engage in that may result in physical injury. I understand and acknowledge that these activities have inherent risks associated with them, and I knowingly assume those risks, release and covenant not to sue the for any liability whatsoever resulting from my child’s participation in the activities of the Camp. In the event of an injury,
I consent to emergency medical attention for my child.
The undersigned hereby agrees to indemnify and save and hold harmless IveyPatton and Valley Camp, from any loss, liability, damage, or cost that may occur as a result of my minor child’s participation in the Camp. The undersigned hereby assumes full responsibility for and risk of bodily injury, death, or property damage due to negligence of The Valley Camp or otherwise while in, about, or upon the premises of the Valley Camp or while on a field trip.
The undersigned has read and voluntarily signs the release and waiver of liability and indemnity agreement, and further agrees that no oral representations, statements, or inducement apart from the foregoing writing agreement have been made.
Signed this _____ day of _______________________, 2012
Parent/Guardian printed name __________________________________________________________________ Parent/Guardian signature _____________________________________________________________________ Participant name (please print) _________________________________________________________________ Address____________________________________________________________________________________ City ________________State ________________Zip Code ____________ Phone__________________________________________
Emergency contact information (please list two contacts): name____________________________________________________phone______________________________ name____________________________________________________phone______________________________ physician_________________________________________________phone_____________________________
Please list any allergies or limitations or medication instructions:__________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Are there any medical, physical, or behavioral issues that we should be aware of? ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________
Valley Camp will be a smooth operation if we all act with respect and kindness, empowering the voices of everyone involved with encouragement, tolerance, and support.
Repeat violaters will be shipped to Siberia.(or home)
I am fully aware, understand and acknowledge that my child(ren) will be involved in physical activities, both outside and indoors, during the Camp, including but not limited to hiking on nature trails, playground activities, interaction with animals, theater activities, gardening, and arts and crafts that my child will engage in that may result in physical injury. I understand and acknowledge that these activities have inherent risks associated with them, and I knowingly assume those risks, release and covenant not to sue the for any liability whatsoever resulting from my child’s participation in the activities of the Camp. In the event of an injury,
I consent to emergency medical attention for my child.
The undersigned hereby agrees to indemnify and save and hold harmless IveyPatton and Valley Camp, from any loss, liability, damage, or cost that may occur as a result of my minor child’s participation in the Camp. The undersigned hereby assumes full responsibility for and risk of bodily injury, death, or property damage due to negligence of The Valley Camp or otherwise while in, about, or upon the premises of the Valley Camp or while on a field trip.
The undersigned has read and voluntarily signs the release and waiver of liability and indemnity agreement, and further agrees that no oral representations, statements, or inducement apart from the foregoing writing agreement have been made.
Signed this _____ day of _______________________, 2012
Parent/Guardian printed name __________________________________________________________________ Parent/Guardian signature _____________________________________________________________________ Participant name (please print) _________________________________________________________________ Address____________________________________________________________________________________ City ________________State ________________Zip Code ____________ Phone__________________________________________
Emergency contact information (please list two contacts): name____________________________________________________phone______________________________ name____________________________________________________phone______________________________ physician_________________________________________________phone_____________________________
Please list any allergies or limitations or medication instructions:__________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Are there any medical, physical, or behavioral issues that we should be aware of? ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________
Valley Camp will be a smooth operation if we all act with respect and kindness, empowering the voices of everyone involved with encouragement, tolerance, and support.
Repeat violaters will be shipped to Siberia.(or home)
PARENT PERMISSION AND MEDICAL CONSENT FORM
Child Name: Birthdate: _______
Address: ____________________
City: State: Zip:
Home Phone: ( ) Work Phone: ________
Parental Consent:
(I) (We), the undersigned, parent(s) of , a minor, do hereby consent to said Minor participating in (explain activity) conducted by .
Authorization of Consent to Treatment of Minor:
(I) (We), the undersigned, parent(s) of , a minor, do hereby authorize , hereinafter “Agent”, for and on behalf of the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under the general or specific supervision of any physician and surgeon licensed under the provision of the Medical Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or at a hospital, during all times that the Minor is in the presence of said Agent.
It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment, or hospital care which the aforementioned physician in the exercise of his best judgment may deem advisable and release Agent from all damages of same.
This authorization shall remain effective through the __ day of , 20 , unless sooner terminated in writing.
Parent_________________________________
Signed
Date:
Parent_________________________________
Signed
Date:
Home Phone Work Phone
Other phone number
Legal Guardian Phone
Other Emergency Contact Phone
Family Doctor Phone
Insurance Co. If None Please Check
Insurance Policy Name and #
Known Medical Conditions
Medications?
Allergies?
Last Tetanus Immunization?
Other
No comments:
Post a Comment