Week of July 24th, 2023- Drop In and Dig Deep

In order to provide a safe and positive experience for all participants, we ask that you provide the following information.

How many people are you registering? *

Fill in your registration information on this page. You will be able to enter the registration information for additional people after you complete this page and click "Continue".

Summer Camp Registration

Camper First Name *

Camper Last Name *

Camper Age (on camp start date) *

Entering Grade *

T-Shirt Size *

Youth X-SMALL (4-5) Youth SMALL (6-8) Youth MEDIUM (10-12) Youth LARGE (14-16) Adult X-SMALL Adult SMALL Adult MEDIUM Adult LARGE Adult X-LARGE

Parent or Guardian First Name

Parent or Guardian First Name *

Parent or Guardian Last Name

Parent or Guardian Last Name *

Relationship to Camper *

List relationship to the camper (e.g. father, mother, grandmother, uncle, etc.)

Parent or Guardian Cell Phone *

Parent or Guardian Home Phone

Parent or Guardian Work Phone

Parent or Guardian's Email *

Parent or Guardian Address *

Zip Code *

Additional contacts will be contacted in case parent/guardian can't be reached in an emergency. They will also be authorized to sign camper in and out unless otherwise requested.

Emergency Contact Name (first & last) *

Emergency Contact Relationship to Camper *

Emergency Contact Phone Number *

Additional Emergency Contact Name (first & last) *

Additional Emergency Contact Relationship to Camper *

Additional Emergency Contact Phone Number *

Camper Information: Known Allergies (or n/a if none) *

Please include food, insect, and any other known allergies. We will do our best to accommodate dietary requirements to the extent we are able. If severe allergies are an issue, please contact the Youth & School Gardens Program Director before registering your child: 801-871-8336.

Camper Information: Medical Conditions and Medication

Please list any medical/health concerns and current medications that WCG staff need to know about. Feel free to omit information that is not relevant to participating in camp or in the event of an emergency.

Camper Information: Any Special Concerns

Please let us know if there are any special concerns we should know about in order to create the most positive experience for your child.

Agree to Terms and Conditions *

I agree to terms and conditions

For your records, you have agreed to the following Wasatch Community Gardens Summer Camp Terms and Conditions:

I am the parent/guardian of the child named above and hereby agree to the following:

1. I consent to emergency medical care of my child by Wasatch Community Gardens and its employees, or health care providers designated by them, in accordance with their best judgment.

2. I understand that WCG Summer Camp registration fees are non-refundable.

3. I give permission to Wasatch Community Gardens to use photos, film, and/or quotes of my child for promotional materials, including the Wasatch Community Garden website.

4. I agree to pick up my child from Wasatch Community Gardens within 15 minutes of the conclusion of the daily programming.

5. I release Wasatch Community Gardens, its employees, agents and board of directors from all claims for injury to my child or damage to my child’s property which may result from or occur during participation in the WCG Summer Camp program and I will indemnify Wasatch Community Gardens and its employees, agents and board of directors for any liability for injury to any person and damage to property caused by my child’s negligent or intentional act or omission.

General Release and Release Consent for Medical Treatment

As the parent or guardian of the participant, I hereby consent that my child may participate in the 2020 Wasatch Community Gardens Summer Camp Program and hereby state that the information contained herein is true and complete.

1. Release. Recognizing the possibility of physical injury associated with Wasatch Community Gardens Summer Camp Program, I hereby release and agree to hold harmless and indemnify including legal cost, as a result of my child’s participation in the program.

2. Emergency Medical Care. I hereby give my consent for emergency medical treatment by Wasatch Community Gardens’ employees or health care provider(s) designated by them, in accordance to their best judgment.

3. Insurance. I understand that I should have health and accident insurance to cover injuries arising from participation in the program.

4. Photos. WCG staff and approved volunteers occasionally take photographs of gardening-related activities at camp for use in promotional materials, and I hereby give consent for my child to be photographed while participating in camp and for those photos to be used in official WCG outreach materials.

How did you hear about WCG Summer Camps this year? *

Thanks for helping us improve our outreach efforts!

Event Fee(s)

WCG+ATS Summer Camp Registration

$500.00

Total for this participant

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Your Registration Info

Phone *

Street Address *

City *

State *

Postal Code *

Week of July 24th, 2023- Drop In and Dig Deep

Wasatch Community Gardens

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