Camp Guggenheim Registration
The online registration form will take approximately 30 minutes to complete, and CANNOT be saved. All information must be completed in its entirety. Once the online form has been completed, please go to the forms tab and print the Healthcare Provider Orders, and the Photo Release Form. Within a day or two of completion of the online registration form, you will receive an email with further instructions and where to fax the hard copy forms.
All hard copy forms: (Healthcare Provider Orders, Medical Insurance Card and Photo Release Forms must be received 2 weeks prior to start of camp, as we are required to have these forms on site at time of camper check in Sunday evening. THANK YOU FOR YOUR COOPERATION.
Please contact the Office of Youth Ministry Director at 518-310-3669 or Youth Office Secretary at 315-293-2920 with any questions or concerns.
Deadline for Online Registration along with all hard copy health forms and insurance information must be submitted by the following dates:
Week 1: June 17
Week 2: June 24
Week 3: July 1
Week 4: July 8
Week 5: July 15
Week 6: July 22
Please schedule your healthcare provider visit in a timely manner to accommodate the registration process. Thank you!
Online registration for all sessions will close 1 week prior to start of camp.
A $100 deposit or the full camp fee of $425 for Sessions 2 to 6 is required at time of registration to reserve your child’s camp session. Upon completion of the online form, you will be forwarded to PayPal and may use a credit card for your deposit or full payment. You can disregard the PayPal page, if someone other than yourself is paying for your child’s registration (the parish, a donor, etc.), you can disregard the PayPal page.
Parent/Legal Guardian Information
Mother/Legal Guardian Information
Father/Legal Guardian Information
If a parent/guardian can not be reached in case of an emergency, please contact:
Permissions
Camp Guggenheim will try to honor roommate requests for first-time Campers.
Section A - Travel Home
By eSigning my name above, I hereby consent to my Camper’s release from Camp Guggenheim at the end of the week.
Section B - Health History
The information provided in this section is not part of the Camper acceptance process, but is gathered to assist our staff in identifying appropriate care. The Health History section must be completed by the parent(s)/guardian(s) of minors.
Insurance Information
A photocopy of the front and back of your health insurance card must be provided. If you are unable to upload your health insurance card, please mail a copy to the Youth Ministry Office, PO Box 369, Ogdensburg, NY 13669 or email to jgrizzuto@rcdony.org.
Healthcare Provider Information
Medication Allergies
Food Allergies
Other Allergies
For Female Camper
General Questions (Explain “yes” answers below)
Camp Guggenheim embraces the uniqueness of every individual and wants every child to have the opportunity to participate at Camp Guggenheim. We encourage Camper's with special needs to attend and participate at Camp Guggenheim.
Which of the following has your Camper had?
Restrictions
The Healthcare Provider's Orders must be completed by your Healthcare Provider and is due to the Youth Ministry Office by June 1. A Camper must have a physical prior to camp within the last year. Campers without a physical will not be able to attend Camp Guggenheim.
Please click here to print the Healthcare Provider's Orders.
Parent/Guardian Authorization:
By eSigning my name above, I hereby affirm and certify that the information provided in Section B - Health History is complete and accurate. My child has my permission to engage in all camp activities except as noted.
I hereby give permission to the Guggenheim staff to provide for my child routine health care (including over-the-counter medication as authorized on the Healthcare Provider's Orders administer prescribed medication in accordance with the written instructions of the Health Care Provider, apply sunscreen, and administer or obtain emergency medical treatment. I agree to the release of any records necessary for insurance purposes. I give permission to the Camp Guggenheim to arrange necessary transportation for my child.
I hereby grant permission to the Guggenheim staff, as “personal representative” of my child while enrolled at camp, to receive any records or results or medical treatment given to my child while enrolled at Camp Guggenheim.
In the event I cannot be reached in an emergency, I hereby give permission to the Healthcare Provider selected by Camp Guggenheim, to secure and administer treatment, including hospitalization, for my child. This completed form may be photocopied for trips out of Camp Guggenheim.
Healthcare Notification Policy
Our healthcare staff will make every effort to contact you by phone, if your child has need for out-of-camp healthcare. Because of timing and scheduling conflicts, we cannot promise that we will be successful in reaching you. In addition to phone contact, we will provide you with a written summary about out-of-camp health care given to your child. We generally do not contact you if your child is seen in the camp health center for routine problems (e.g. skinned knees, sore throat, and headache) that do not require a Healthcare Provider's referral. The decision to consult you for routine, in-camp healthcare is determined on a case by-case basis for our Healthcare Provider. You will typically be notified if your child visits the health center with a repeated complaint, or if your child’s condition does not improve in a reasonable amount of time.
By eSigning my name above, I hereby affirm and certify that I have read and understand the Health Care Notification Policy.
Over-the-counter Medications
By eSigning my name above, I hereby understand and affirm that I may not send my child to Camp Guggenheim with over the counter medication(s) that my Healthcare Provider has not signed for on the Healthcare Provider's Orders Form. I also understand the dosages will be administered according to the Healthcare Provider's orders. I also understand that Camp Guggenheim staff cannot administer over-the-counter medication even if the healthcare center has it in stock if a child does not have a Healthcare Provider's Order for that medication. I understand that all medication must be given to the Camp Guggenheim medical director and that campers may not keep any medications in their personal belongings (other than emergency medications, such as inhalers and epi-pens, as per the physician's directions).
Meningococcal Conjugate Vaccine:
By eSigning my name above, I hereby affirm and certify that the option I selected above is my preference regarding the Meningococcal Conjugate Vaccine.
Measles Vaccine:
Campers who have not received the Measles vaccination will be treated on a case by case basis.
By typing my full name (electronic signature) above, I hereby affirm and certify that the option I selected above is my preference regarding the Measles Vaccine.
Waiver and Release of Liability; Indemnification and Hold Harmless Agreement
In order for my child to participate in the Roman Catholic Diocese of Ogdensburg’s Summer Camp, I agree as follows:
1. Acknowledgement of Risk. Camper, Parent(s) and/or Legal Guardian(s) acknowledge and fully understand that there are inherent risks of serious injury or death associated with rappelling, hiking, backpacking, biking, swimming, canoeing and other activities associated with the camp experience. These inherent risks include, but are not limited to: encountering natural dangers such as falling rocks or objects, irregular or uneven ground, unseen and unmarked objects, drowning or serious injury in and around water could occur due to water movement, subsurface conditions, cold water temperature, water impurities and the like. Inherent risks also include acts or omissions of other Campers, the condition of equipment or property, even if properly maintained; weather conditions (such as lightening strikes, sunburn, rain or hail storms, tornadoes and the like), contact with plants, animals or insects, the risk of Camper engaging in unauthorized activities, Camper’s physical conditions or Camper’s own acts and omissions, conditions or roads, trails, waterways or terrain, the administration and availability of first aid and emergency treatment and consumption of food or drink by Camper. Camper, Parent(s) and/or Legal Guardian(s) further acknowledge that the inherent risks associated with activities at Summer Camp, including rappelling, hiking, backpacking, biking, swimming and canoeing cannot be comprehensively described as part of this document.
2. Assumption of Risks. Camper, Parent(s) and/or Legal Guardian(s) hereby release, waive and discharge Summer Camp, its employees and agents from liability claims and demands of negligence on the part of Summer Camp, its employees and agents arising in connection with the participation in Summer Camp activities and use of Summer Camp facilities and equipment, including, but not limited to, those risks described in paragraph #1 above; providing, however, that this waiver and release does not include injury, damage, or loss as a result of the gross negligence of Summer Camp, its agents or employees.
3. Indemnification and hold harmless. Camper, Parent(s) and/or Legal Guardian(s) further agree to indemnify and hold harmless Summer Camp, its employees and agents, against all losses, damages, monetary awards and expenses, including all costs and attorneys fees incurred in connection with any and all claims of negligence on the part of Summer Camp, its employees and agents, brought by Camper, Parent(s) and/or Legal Guardian(s), his or her heirs, successors, assigned and legal representatives for any injury, death, illness, disease or damage to property, arising from or connected with participation in any activity of Summer Camp. The indemnification and hold harmless agreement does not include losses, damages, monetary awards and expenses as a result of the intentional or reckless acts of Summer Camp, its employees and agents.
4. Miscellaneous. The parties agree that the provisions of this “Waiver and Release of Liability; Indemnification and Hold Harmless Agreement” (“Agreement”) shall be deemed severable and that the invalidity or unenforceability of any one or more of the provisions of clauses hereof shall not affect the validity or enforceability of the other provisions or clauses hereof except as specifically set forth herein. The terms of this Agreement constitute the entire agreement and understanding between the parties. This Agreement is made pursuant to and shall be construed under the laws of the State of New York.
5. Opportunity to Negotiate. You are encouraged to carefully review the contents of this Agreement and take the time you feel necessary to review it. DO NOT SIGN THIS AGREEMENT UNLESS YOU UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS OF THIS AGREEMENT. You may wish to consult an attorney. If you wish to negotiate any of the terms of this Agreement for modifications, deletions or additions, please contact the Roman Catholic Diocese of Ogdensburg Youth Ministry Center Director (“Director”) at (315) 393-2920 ext. 1401 prior to signing and executing this Agreement. If you do not contact the Director prior to signing and executing this Agreement, Summer Camp understands that you are accepting the terms and conditions as set forth above, and that you do not wish to pursue any further negotiations regarding the terms and conditions of this Agreement.
By eSigning my name above I CERTIFY THAT I HAVE READ THIS AGREEMENT AND THAT I UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS AND ASSUMING SUBSTANTIAL RESPONSIBILITIES BY SIGNING IT, AND THAT I SIGN IT VOLUNTARILY.
The consent for release of audio, photograph and video for campers must be completed online. Please click here to fill out the form.
