2018 Rise-Up Camp Registration Form

Rise-Up Camp is a unique outdoor activity camp designed to teach youth ages 10-17 practical, hands-on skills they will need as adults. Youth will try out new skills without fear of failure, get inspired to learn more, build confidence, and leave knowing their community has their back.

We will have fun learning basic carpentry, mechanical, sports, and automotive skills. At the end of the week, camp attendees will get the satisfaction of donating a hand-crafted project back to the community.

On Friday evening (the last day) we will invite the whole community out to celebrate with a free dinner and hip-hop concert (family-friendly).

Snacks and dinner included!

Date:             July 9th - July 13th, 2018
Time:            2:00pm until 7:00pm
Location:      Skyway Park
Cost:             Free, but registration required

Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Phone *
Parent/Guardian Phone
Home Address *
Home Address
Name of Youth *
Name of Youth
Youth Birthdate *
Youth Birthdate
Checkbox *
Consent and Release of Liability: I give consent to the child listed above to participate in Rise Up Camp activities. I understand that some of these activities may involve a possible risk of harm, and I agree to hold the staff, volunteers, and sponsoring organizations free from liability to the extent permitted by law. I give permission for photos taken during camp to be used by Rise Up Camp for any legal purpose. Emergency Medical Release: By submitting this form I give permission for the child listed above to receive emergency medical care due to sudden illness or injury during the dates given at the top of this form. I release the volunteers, staff, sponsoring organizations, and medical personnel from liability for the medical treatment given, including any treatment given by 911 emergency medical responders. Parent/Guardian Authorization: By clicking "I agree" below, I represent that I am the parent or guardian of the child I have listed, and that I have the authority to authorize this consent form. NOTE: At Rise Up Camp 2018, we will be having a horse demonstration but no horse riding will be offered.