Youth Full Legal Name
Youth Preferred Name
Date of Birth
Years of Experience
Do you have a financial need? Explain.
Parent / Guardian Name (1)
Parent / Guardian Phone (1)
Parent / Guardian Name (2)
Parent / Guardian Phone (2)
Parent / Guardian Name (3)
Parent / Guardian Phone (3)
Elementary Choral - Ages 9-12 • 10:00am-4:00pm
The primary focus will be on technique, repertoire, and music theory in a group setting. In addition, students will have the opportunity to enjoy outdoor activities. A public performance will be the culminating event in which students can publicly display their progress.
Instrumental - Ages 13-17 • 9:00am-5:00pm
The primary focus will be technique, ensemble repertoire, and music theory in a group setting. In addition, students will have the opportunity to enjoy outdoor activities. A public performance will be the culminating event in which students can publicly display their progress.
Piano - Ages 9-17 • 9:00am-5:00pm
The primary focus will be technique, repertoire, and music theory. In addition, students will have the opportunity to enjoy outdoor activities. A public performance will be the culminating event in which students can publically display their progress.
In addition to the parents/guardians listed above the following individuals may pick-up my child:
List NAME, PHONE NUMBER, & RELATIONSHIP TO CAMPER of authorized individuals to pick-up camper.
Pick Up Approval List
After attempting to contact the parents/guardians listed above, please contact the following individuals in the case of emergency:
Camper's Physician Phone
For campers who reside WITHIN the United States, a United States Territory, or the District of Columbia
Camper's state of residence
Is this child exempt from any immunizations?
If yes, tell us why:
For campers who reside OUTSIDE the United States, a United States territory, or the District of Columbia
Country in which child resides
Attach Department form DHMH-896 (record of vaccination or immunity)
Please tell us about any allergies. Mark all that apply:
If other, tell us about it
Does your child carry an EpiPen
Are there any other physical, psychiatric, behavioral or emotional conditions of which we need to be aware? Mark all that apply:
If your child has needs that require special attention, please e-mail us at firstname.lastname@example.org at least four weeks in advance so we can do our best to accommodate them.
If your child must either carry or be given ANY medication during program hours, the Medication Administration Authorization Form is required by the MD State Department of Health. No medication will be accepted without the completed Authorization form. Access the form at http://bit.do/campmeds . If you have any questions, please call 301.387.3129.
IN THE EVENT OF AN EMERGENCY, you agree to release and hold harmless Garrett College, whose first aid certified staff may administer first aid to your child as needed and authorize Garrett College staff to secure from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for your child’s immediate care and agree to be responsible for payment of any and all charges for medical services rendered.
My child has my permission to be photographed, interviewed, or videotaped while attending any Garrett College Camp for possible use in print or web marketing. I release Garrett College, its Board of Trustees, officers, agents, directors, faculty/staff , and assigns from any and all claims(monetary or otherwise) that you may have related to the use of these images.
I give permission for my child participate in camp field trips (as applicable), including travel to and from the destination. In consideration of the advantages of participation in field trips, the undersigned agrees that the Garrett College, its agents and employees, and the driver and/or owner of the vehicle used for the field trip shall be released and exempt from any liability for damages for bodily injuries or property damages that may occur during the trip, except to the extent of insurance liability as provided by law.
Permission to travel:
Garrett College Camps are aware of how damaging UV rays from the sun can be to your child’s skin. During the summer months, or when necessary, campers will apply sunscreen approximately thirty minutes before going outside, and in 1 hour intervals during on and off-campus outside activities. Garrett College requests that parents supply one bottle of sunscreen prior to expiration date with their child’s first and last name labeled on the bottle. Parents will be informed when a new bottle is needed.
If your child has an allergy to sunscreen a doctor’s note must be provided and will be attached to this policy and kept in your child’s folder. Garrett College will take other precautions to protect your child from overexposure to the sun, such as: wearing a hat and playing in shaded areas. I further give Garrett College Camp Staff permission to apply, or supervise the application of an SPF sunscreen that I have provided for my child should they require and ask for assistance.
Agree and approve application assistance if required:
Timely Pick Up
Late pick-ups will be recorded. Parents should make every effort to pick-up their children no later than the advertised camp end time (varies by camp, please consult your camp’s specific hours). Please consider weather and traffic conditions when making your pick-up arrangements. If a child is not picked up by the advertised camp end time., the following policy will be followed:
Events will happen that are out of our control, but please consider having a back-up plan or two in place for those times. I agree to the policy as stated above. Please type your initials below to signify acceptance.
Informed Consent/Assumption of Risk
I have registered my child for Garrett College Camp(s) sponsored by Garrett College. I understand that participation in this activity/course involves inherent risks of injury, and that the nature of the risks may vary depending upon the type of activity, instructor, and my child’s physical condition and conduct. I acknowledge that I will either ask for or have been given any information that I need to determine the general risks associated with this camp and its activities. I agree that my child will follow advised precautions and conform to all rules and policies of the department, instructor, and any other sponsor of this course/activity.I voluntarily assume all risks of loss, damage, illness, or injury which my child may sustain while participating in this camp and its activities, including travel and usage of any equipment or facilities. I will make no claim against and do hereby fully and unconditionally, forever release, waive, discharge, hold harmless and indemnify, on behalf of myself (my child), my personal representatives and my heirs, Garrett College and its Board of Trustees, officers, agents, and employees from any and all claims and causes of action for any injury or loss, or for damages, costs, expenses, or compensation that may occur during or result from my child’s participation in this camp and its activities, whether arising through the negligence, omission, default, or other action of any person or event associated with this course or event, including fellow participants.
By typing your name below, you decree that you agree to the following statement: I have read and understand the above information. I give my permission for my child to participate in this camp and its activities and grant the same informed consent, assumption of risk, and release for myself (for my child), estate, successors, and assigns, and the child’s family.
I have read the above disclaimers and agree to timely pickup and informed consent:
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, is extremely contagious and believed to be spread by person-to-person contact. Many federal, state, and local governments and federal and state health agencies, including the CDC, recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Garrett College has instituted measures and procedures intended to reduce the spread of COVID-19. However, the college cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending camp could increase your risk and your child(ren)’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of contagious nature of COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I understand that while the college has undertaken reasonable steps to lessen the risk of transmission of COVID-19, the college is not responsible in any manner for any risks related to COVID-19 in connection with the Garrett College sponsored summer camps. I voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the camp and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the camp may result from the actions, omissions, or negligence of myself and others, including, but not limited to, camp employees, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself, (including, but not limited to, personal injury, disability, and death).
On behalf of myself, my children, my heirs, and any personal representatives, I hereby release, covenant not to sue, discharge, and hold harmless the college, its employees, agents, and representatives, any and all causes of action, claims, demands, damages, costs, expenses, and compensation for damage or loss to myself or child(ren) that may be caused by any actions, omissions, or negligence of the college, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any camp program.
I have read the COVID-19 waiver and agree:
Upon submitting this form our camp directors will be alerted. You should receive an email confirmation with this form attached. Please keep for your records.
By providing your information, you consent to being contacted by Garrett College. You have the right to withdraw your consent at any time, and the right to request that Garrett College update, erase, or transfer your data.