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Tri-State Connection Registration Form

Birthday
Month
Day
Year
Multi-line address
Severity of Food Allergy
Mild
Moderate
Severe

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*Deluxe rooms house up to 4 people and share a bathroom and are offered at a first register/first serve basis. Bunk dorms house 5-10 people who share a bathroom.

Tri-State Payment

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Tri-State Liability Wavier

Participation in camp activities may involve inherent risks of physical injury, or in extreme cases potential loss of life. I, the participant, assume these risks and releases Camp Selah, its staff and Board of Directors from claims, injuries, or liability related to my participation, except in cases of intentional misconduct by the camp or its staff.

In case of emergency, if my emergency contact cannot be reached, I give permission to Camp Selah staff to seek medical attention on my behalf. I acknowledge responsibility for all medical bills incurred by me during my participation.

I agree to defend and indemnify Camp Selah against claims arising from my own negligence or fault during my participation. I also agree to indemnify the camp against claims brought by myself or my family members, unless the claim results from the intentional misconduct or sole negligence of the camp or its staff.

I grant the camp the right to use photos and videos of me for promotional purposes across various media. This may include use in newsletters, websites, social media, and presentations.

I, the participant, agree to follow all camp rules and policies, which may cover areas like prohibited items--drugs and alcohol, observing quiet hours, and behavior. Failure to comply could lead to dismissal from camp without a refund.

By signing this form, I acknowledge that I have read, understand, and agree to all provisions of the form, recognizing I am giving up substantial legal rights.

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