Register

Camper's Name *

First

Last

Email *

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Address *

Phone *

Age *

Birthdate *

month/day/year

Sex *

Male
Female
Prefer not to answer

Grade *

School Attending *

Does camper attend special education classes? *

Yes
No

Primary Disability *

Secondary Disability *

Please indicate the type of equipment your child will have at camp *

Manual wheelchair
Power wheelchair
Other

Specific Shirt Size *

Waiver For and in consideration of Colorado Sports for the Physically Challenged, Inc., National Sports Center for the Disabled and the sponsors of this program, I the undersigned for myself, or anyone whom I am signing on behalf of, successors and assignees, agree and to sue, and to release and forever discharge Colorado Sports for the Physically Challenged, Inc., National Sports Center for the Disabled and each of their officers, employees, agents and assignees, from any and all liabilities, demands, or claims for loss or damage resulting from any injury or damage which may be sustained arising out of my participation in the Junior Wheelchair Sports Camp. I hereby also consent to allow medical treatment in case of emergency. Entry in, participation in or attendance of the Colorado Junior Wheelchair Sports Camp constitutes permission to be photographed for possible publicity, promotional or media purposes and constitutes a waiver of any and all claims for compensation from all sponsoring agencies.

I Agree

Applicant’s Signature *

Signature of Parent/Guardian (if under 18) *

Date *

Witnessed By *

Date *

MEDIA RELEASE: Colorado Junior Wheelchair Sports Camp (CJWSC) uses photographs, slides, videos, or illustrations of campers for many purposes related to CJWSC business. This form allows you to grant or deny permission to CJWSC to release your child’s image for display or publication. This form also allows a parent or guardian to choose whether or not their child may be identified by name on the CJWSC website. Camper's names may be released unless a parent or guardian has expressly contacted the camp and requested their child’s “information” not be shared. However, as a safeguard, the CJWSC does not directly publish campers names to the Internet unless given permission by a parent or guardian. (copy) *

I grant permission for use of my child’s image in print, video and/or digital media. I understand that my child’s image may be used or released by CJWSC without additional notification and that my child’s name may appear along with his or her photograph
I deny permission to use my child’s image for display, publication or release to external organizations.

The CJWCSC will be following all local health codes as they pertain to COVID-19 protocols by Adams County, Aurora County, and Aurora Public Schools. This includes mask mandates, vaccinations by those involved in the CJWCSC, camper, sports instructors, and volunteers. https://www.tchd.org/

I understand