Join Us at Summer Camp (ages 11-13)

2026 Summer Camp Registration (Ages 11 - 13)

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Phone

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Please complete the following 2026 Summer Camp registration form.

Parent / Guardian Information

Parent / Guardian Name*

First Last

Parent / Guardian Email Address*

Parent / Guardian Address*

Street Address Address Line 2 City State ZIP Code

Parent / Guardian Phone Number*

Relationship to Camper*

Camper Information

Camper's Name*

First Last

Age of Camper*

Please enter a number from 11 to 13.

Used to confirm age eligibility

Camper's T-Shirt Size*

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Camper Session Attending

Emergency Contacts

Emergency Contact 1*

Emergency Contact 1 Phone Number*

Emergency Contact 1 Relationship to Camper*

Emergency Contact 2

Emergency Contact 2 Phone Number

Emergency Contact 2 Relationship to Camper

Medical Information

Please list any medical issues that our team should be aware of

Does your child have any known allergies?*

Yes

If yes, what is your child allergic to and what is the reaction?

Does your child have any special education needs (i.e. ADHD)?*

Yes

If yes, please share any modifications that would help your child be successful

Question not required

Please list any medications that your child will be bringing to camp

Consent

Waiver and Release of Liability

By registering my child for camp at the Humane Society of Macomb, I acknowledge and agree to the following: I understand that camp activities include direct interaction with animals, including but not limited to animal handling, feeding, and grooming, as well as arts and crafts and other activities. I acknowledge that participation involves inherent risks, including but not limited to scratches, bites, allergic reactions, slips, falls, and other injuries that may result from activities or contact with animals. I, on behalf of myself, my child, and our heirs, estates, and assigns, hereby release and agree not to sue the Humane Society of Macomb, its officers, directors, employees, volunteers, and agents from any and all claims, liabilities, damages, or expenses arising out of my child's participation in camp activities, except to the extent caused by gross negligence or willful misconduct. I understand that while staff will provide supervision and instruction, working with animals carries risks that cannot be entirely eliminated. I voluntarily assume all such risks on behalf of my child. I agree to inform the Humane Society of Macomb of any changes to my child's health, medications, or abilities that may affect their participation.

Photo and Media Release

I grant the Humane Society of Macomb permission to photograph, video record, or otherwise capture my child's image and voice during camp activities. I authorize the Humane Society of Macomb to use these images and recordings for promotional, educational, and fundraising purposes, including but not limited to use on the organization's website, social media accounts, newsletters, and printed materials. I understand that my child's name will not be associated with any image without my separate written consent. I waive any right to compensation or approval for such use. This authorization remains in effect unless I revoke it in writing.

Parent/Guardian Acknowledgment

By submitting this registration, I confirm that:

I am the parent or legal guardian of the participant named in this registration.
I have read and understand the Waiver and Release of Liability and the Photo and Media Release above.
I agree to the terms and conditions stated herein on behalf of myself and my child.
The information I have provided on this form is accurate and complete.
I will notify the Humane Society of Macomb promptly of any changes to emergency contact information or my child's medical status.

By typing your name below, you agree to and consent to the terms and conditions*

Early Bird - Register before May 31st

Price:

Cancellations made prior to one (1) week before the start of camp are eligible for a refund, less a $50.00 cancellation fee per camper.Cancellations made within one (1) week of the camp start date are non-refundable.

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