Camp Guggenheim Registration

HIKE! SWIM! PRAISE!

We look forward to another great summer of faith-filled fun! Below is the online registration form, and links to other needed forms to complete the registration process. In addition to the form below, we will need your camper’s doctor to complete and return the Medical Form and provide the camper's Vaccination Record, as well as agreeing to a payment plan to cover the costs.

Once all of these are complete then your camper will be all registered! You are always welcome to contact the Office of Youth Ministry Director at 315-854-2894 or the Youth Ministry Secretary at 315-393-2920 with any questions or concerns. Sometimes people have technical issues with the online form. We know this can be frustrating but just give us a call and we can help.

How to Register:

Step 1: Fill out the online form below. If you have any technical issues with the form, simply give us a call. We can help. There is a brief medical history section. We have included the items that we know we need for our nurse, but please use the free-response sections to add other things you want us to know. (Special diet restrictions, uncommon conditions, activity restrictions, etc) The more we know, the better! And sometimes the doctor doesn’t include things that have happened since their last exam.

Step 2: Tell us how you are going to pay for camp. In order to be considered “registered” you will either need to pay at least a $100 deposit today or fill out a financial assistance application. Some families pay for camp on their own. Some are sponsored (fully or partially) by parishes or other groups. Some are granted financial aid through our scholarship program. We have generous donors who give us a pool of scholarship funds, but we do ask applicants to reach out to their parish or local KoC (or similar group) before we grant funds. We can help you with that process. Filling out the application starts the ball rolling! We never want the cost of camp to get in the way of someone attending! If you are not seeking financial aid, then you can pay in full, or in installments.

Step 3: Download and Complete the Medical Form. No one likes forms, but they are a fact of life! Plus, they help us keep your camper safe and healthy! The Medical Form B needs to be downloaded and sent to your PCP. The exam information they provide needs to be within 12 months of their Camp Start Date (e.g. a school/sport/annual physical). So, if your camper hasn’t had a physical in a while, make sure you schedule that now, so you aren’t scrambling. We need to receive this form within 1 week of camp so that our nurse can verify everything. Per New York State Department of Health regulations, camps are required to maintain a current immunization record for each camper, including measles immunity, proof of immunity, or a valid medical exemption. Campers may not attend camp without required documentation. If you have any questions or concerns, please contact us. Make sure to fill out the parent/guardian section before sending it to your doctor. They/you can either mail it back to us, or scan and email it.

Camp Guggenheim Registration

If we receive your registration with payment agreement by March 1, the fee for camp is only $425 per session; after March 1, the fee will be $450.

Please select the week your Camper would like to attend:(*)

Session 1: July 5 to July 10 (11 -13 yrs old)

Session 2: July 12 to July 17 (12-15 yrs old)

Session 3: July 19 to July 24 (12-15 yrs old)

Session 4: July 26 to July 31 (12-15 yrs old)

Session 5: August 2 to August 7 (16-18 yrs old)

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Camper's First Name:(*)

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Camper's Last Name:(*)

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Campers Date of Birth:(*)

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What age will you be at Camp:(*)

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Grade in the Fall '26:(*)

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Sex:(*)

MaleFemale

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Street Address:(*)

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Mailing Address (if different):

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City:(*)

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State:(*)

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Zip Code:(*)

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A Photo Release Form is required for each camper. We have one for minors under 18 and for adults 18+. Which one will your camper need based on their age at camp this summer:(*)

under 18

18+

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Please click here to download and fill out the Photo Release form or click here to fill out a digital form.

DIOCESE OF OGDENSBURG
PUBLICATIONS/WEBSITES/SOCIAL MEDIA
AUTHORIZATION RELEASE

This authorization release form shall serve as parental/legal guardian permission for the use of the first name and last name’s first initial, likeness and/or photographic image of a child/youth where such permission is required. I hereby give permission for my child’s/youth’s name, photographic image (still or video) to appear in Diocesan, Parish, School, or Organization publications and/or websites/social media sites, marketing initiatives. No consideration, monetary or otherwise, shall be paid.

I understand that if, for whatever reason, at any point in time, I decide to revoke this agreement and I so notify the Parish, School or Organization in writing, all references to my child’s/youth’s name, likeness and/or photographic image will no longer be used. I understand that website/social media references and website/social media photographic images will be removed within thirty (30) days of written notification. I understand that the Diocese, Parish, School or Organization is not responsible for access to the information or downloads made by users using websites or social media sites prior to the removal of references (i.e., name, likeness and/or photographic image). I further understand that my child’s/youth’s name, likeness and/or photographic image may continue to be used in any publications already printed or published prior to my revocation of the consent provided herein.

Child's First Name:(*)

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Child's Last Name:(*)

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Child's Date of Birth(*)

Please use MM/DD/YYYY format.

Permission:(*)

I DO grant permission for the use of my child's/youth's name and I DO grant permission for the use of my child's/youth's photographic image (still or video). OR

I do NOT grant permission for the use of my child's/youth's name but I DO grant permission for the use of my child's/youth's photographic image (still or video). OR

I do NOT grant permission for the use of either my child's/youth's name or photographic image (still or video) to appear in Diocesan, Parish, School or Organization publications and/or websites/social media sites.

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E-Mail:(*)

Please enter valid email address.

Parent or Guardian Full Name(*)

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Today's Date:(*)

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Your child will receive a keepsake Camp Guggenheim T-Shirt! Please choose the appropriate size for your child keeping in mind that they are “adult” sizes. (*)

SmallMediumLarge X-LargeXX-Large

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Parish or Church Name:(*)

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Is this the Camper's first time attending camp?(*)

YesNo

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Camp Guggenheim will try to honor roommate requests for first-time Campers.

Name(s) of other Camper(s) child is requesting to share a room with:

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Travel Home

Besides the parent/guardian(s) listed below, does anyone else have your permission to pick your camper up from camp:(*)

YesNo

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Please list the names and cell numbers for this permission:

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eSignature of Parent/Guardian:(*)

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By eSigning my name above, I hereby consent to my Camper’s release from Camp Guggenheim to the above listed person.

Parent 1/Guardian Information

Last Name:(*)

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First Name:(*)

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Primary Phone Number:(*)

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Email:(*)

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Address same as Camper:(*)

Yes

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Street Address:(*)

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City:(*)

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State:(*)

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Zip Code:(*)

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Parent 2/Guardian Information

Last Name:

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First Name:

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Primary Phone Number:

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Email:

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Address same as Camper:

Yes

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Street Address:

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City:

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State:

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Zip Code:

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If a parent/guardian can not be reached in case of an emergency, please contact:

Emergency Contact Name:(*)

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Phone Number:(*)

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Relationship to Camper:(*)

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Medical Information

Name of Primary Care Physician:(*)

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Physician Phone Number:(*)

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Dentist/Orthodontist:(*)

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Dental Phone Number:(*)

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Does your camper have any known allergies or intolerances to food:(*)

Yes

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Please explain the allergy, any medication needed, and any Emergency Action Plan:

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Does your camper have any known allergies or intolerances to medication:(*)

Yes

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Please explain the allergy, any medication needed, and any Emergency Action Plan:

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Does your camper have any known allergies or intolerances to the environment:(*)

Yes

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Please explain the allergy, any medication needed, and any Emergency Action Plan:

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Does your camper have any other known allergies or intolerances:(*)

Yes

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Please explain the allergy, any medication needed, and any Emergency Action Plan:

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Will the camper be bringing any prescription medication(*)

Yes

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Please list the medications. All medications must be in the original container and labeled properly:Please explain the allergy, any medication needed, and any Emergency Action Plan:

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Will the camper be bringing any OTC medication:(*)

Yes

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Please list the medications. Your doctor will have to approve on Medical Form B. All medications must be in the original container and labeled properly

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Does your camper have any chronic conditions or special needs:(*)

Yes

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Please explain, including any restricted activities

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Does the camper need to carry any special medical device (Epipen, Inhaler, etc):(*)

Yes

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Please describe the device and the permissions for use. Your physician will need to approve on Medical Form B:

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Has the Camper had any recent illness, injury, or surgery that would prohibit them from participating in any camp activities:(*)

Yes

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Please describe the condition and which activities:

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Permissions for Camp Activities

I give permission for my Camper to swim.(*)

YesNo

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I give permission for my Camper to use a non-motarized boat:(*)

YesNo

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I give permission for my Camper to participate in rappelling activities.(*)

YesNo

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I give permission for my Camper to participate in off site activities. (Outside Camp Guggenheim Facilities) i.e. hiking, service projects. Transportation will be provided in staff vehicles.(*)

YesNo

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Measles & Immunization Requirement (New York State Law)

FORM B – Medical Form is required for every camper. Please fill out the top of the form and give it to the camper’s physician. The information must be from an exam within 12 months before attending camp. If the camper has not had a physical in a while, please schedule this soon. By law, we cannot allow any camper to stay at camp without this form.

Electronic Signature of Parent/Guardian:(*)

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By typing my full name (electronic signature) above, I hereby affirm that I understand that New York State law requires campers to be appropriately immunized against measles and other vaccine-preventable diseases, with physician-approved medical exemptions only, and that required documentation must be provided prior to my child’s attendance at camp.

Is there anything else we should know from a medical perspective, or any restrictions or ways we may adapt activities for your camper:

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Insurance Information

Is the Camper covered by health insurance:(*)

YesNo

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Insurance Company:

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Policy Holder Name:(*)

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Relationship to Camper:(*)

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Policy Number:(*)

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Customer Service Number on Card:(*)

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Uninsured Camper – Financial Responsibility & Indemnification

I acknowledge that my child is not covered by any health insurance at this time.

I understand that in the event of illness or injury requiring medical treatment during participation in Camp Guggenheim, all medical expenses incurred are my sole responsibility.

I agree to indemnify and hold harmless the Roman Catholic Diocese of Ogdensburg, Camp Guggenheim, and their officers, employees, volunteers, and agents from any claims for unpaid medical expenses arising from such treatment, except to the extent caused by gross negligence or willful misconduct.

I understand that emergency medical care will be provided when deemed necessary for the health and safety of my child, regardless of insurance status.

eSignature of Parent/Guardian:(*)

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Scholarship

Will you be applying for a scholarship?(*)

YesNo

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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.

eSignature of Parent/Guardian:(*)

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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

eSignature of Parent/Guardian:(*)

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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).

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.

eSignature of Parent/Guardian:(*)

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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.

Roman Catholic
Diocese of Ogdensburg

Camp Guggenheim Registration

Camp Guggenheim Registration

PHYSICAL ADDRESS

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CONTACT

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