Registration Form

Use this form to register your student for the Vikings Running Camp.

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* 1. Name:

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* 3. Phone (optional):

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* 4. School Student Attends

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* 5. Grade Entering

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* 6. T Shirt Size

Location: North Wilkes High School traveling to Cub Creek Park, W. Kerr Scott Lake and Stone Mountain State Park

Mode of Transportation: Activity Bus

Departure Date/Time: June 22-25 8:00am Return Date/Time: June 23-25 12:00pm

Cost for Camp: $80

By submitting this form I request that the student named above be allowed to participate in the Vikings Running Camp identified above. I understand the risks inherent in participation in this camp and specifically consent to his/her participation. In the event of an accident or a medical emergency, I authorize school officials and/or camp directors to seek and consent to emergency medical assistance on the student’s behalf. I understand that the Wilkes County Schools and/or the camp does not or may not have insurance coverage for injuries resulting from camp activities, and I assume responsibility for all expenses. I further understand that school officials and/or camp directors will use the contact information provided on this form to contact me in the event of an accident or emergency.

Changes/Cancellations:

I understand camp activities may be canceled when necessary by camp directors or school officials The camp and/or the school system cannot guarantee reimbursement when such cancellations occur. Parent(s)/Guardians will be notified of any significant change in plans prior to the camp.

Expectations/Instructions:

I understand that throughout this camp students are expected and required:

• To follow instructions of the camp directors, school officials and volunteers.

• Not to leave or separate from the group without appropriate authorization from the camp directors, school officials or volunteers.

• To comply with all school and district policies and rules of conduct.

In the event any of the above expectations or requirements are violated, I understand school officials and/or camp directors reserve the right to remove the student from the activity and/or the camp.

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* 7. I have read and agree to the above terms.

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