Application & Medical Release

Application & Medical Release

NEW THIS YEAR! YOU CAN NOW APPLY AND PAY ONLINE!

You can choose how you would like to apply and pay for your summer session:

  • complete the application form below and pay with PayPal or mail payment (by check payable to Camp Ne-O-Tez) to the director of your chosen week(s) within 21 days of the camp week. Includes a convenience fee of $3 PreCamp or $6 full week.
  • download and print mail-in application below, fill it out and mail with payment (check payable to Camp Ne-O-Tez) to the director of your chosen week within 21 days of the camp week.

PreCamp Session is $80; all other sessions are $180. Online application adds convenience fee.

2017 Camp Ne-O-Tez Summer Camp Mail-In Application

Summer Camp Application (-MS)

CAMPER INFORMATION

in 2016-2017 school year

PARENT/GUARDIAN INFORMATION

Camp does not share or sell email addresses. You may unsubscribe at any time.

SESSION SELECTION

Select the desired week and either apply and pay online or apply online then mail a check payable to Camp Ne-O-Tez to the director of the camp week chosen. Online payees do not need to contact the director of the camp week chosen. Your director will receive your application, medical release and payment verification if you pay online. Do not mail this application to Camp Ne-O-Tez in DeSoto, MO. This application may be used for campers attending up to two sessions. Camper age groups are based on the camper’s grade during the 2016-2017 school year.

MEDICAL AUTHORIZATION AND RELEASE FORM

This section must be completed to attend Camp.

Please check and describe in pop-up box below.

Emergency Authorization and Release: By signing below, I, the parent or legal guardian of the camper (hereby referred to as “my camper”), certify that he/she has my approval to participate in all activities during a camp session. I also certify that the above information is accurate. By signing below I give my permission to camp personnel to administer medications listed above, unless checked, and medications that are supplied by me for my camper. In the event I cannot be reached in an emergency, I hereby give permission for my camper to be transported to and receive medical treatment. I understand I assume financial responsibility for expenses incurred for said treatment. I release and hereby agree to hold harmless the camp, director and staff and any other agents from any and every claim arising, which may be asserted by me or any member of my family, by reason of participating in any activities associated with Camp Ne-O-Tez. Further, I release the owner of properties on which the camp is located. This form may be copied for use outside of Camp Ne-O-Tez. I agree that matters of public health and safety will be directed by Ne-O-Tez policy and the judgment of the Director of the week and/or the Camp Ne-O-Tez Board of Directors. Media Release: Further, for valuable consideration received, by signing below I hereby irrevocably grant to Camp Ne-O-Tez, Inc. the worldwide, royalty-free, right to use my camper’s voice, likeness and image in any forms and media, in all manners for any lawful purposes, commercial or noncommercial.

Use your trackpad to draw your signature or to type your name as a signature, choose the Type It tab and click in the upper left corner of the box to type your signature.Your electronic signature is legally binding in Missouri. See Missouri statute.

Membership has its privileges

†Name of member required; type below. Discount subject to membership verification. Vouchers may only be used one time.

Show me the money

(Includes convenience fee of $3 for PreCamp and $6 for each full week.)

Robots cannot apply.