Application & Medical Release

Application & Medical Release

Let’s go to Camp in 2018! Plan to attend one or more weeks this year. Download an application & medical release Camp Ne-O-Tez Summer Camp Application 2018 or apply online today. If you are applying 30 days or more before your week, you may pay either the deposit or full amount. You will receive a PayPal invoice for any balance due before your week.

2018 Camp Ne-O-Tez Schedule

Week of Camp Dates Director
Pre-Camp (K-2nd grade) June 10-12 Allen Burnett, O’Fallon
High Teen (9th-12th grade) June 17-23 Matt Earnhart, McKnight Crossings
Middle School (6th-8th grade) June 24-June 30 Mike Brown, Lafayette
Family Camp July 1-3 Ed Tritschler
Boys’ Session (3rd-5th boys) July 8-14 Scott Cody, Maryland Heights
Girls’ Session (3rd-5th girls) July 15-21 Rick Burrow, Fairview Heights
All Teen (6th-12th grade) July 22-28 Lane Hamm, McKnight Crossings

Summer Camp Application

CAMPER INFORMATION

in 2017-2018 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 2017-2018 school year. See the Family Camp page for more information for that session.

Applications submitted 30 days or more before camp week chosen are eligible to pay deposit amount. You will receive a PayPal invoice for the balance due before your camp week start date. For applications submitted less than 30 days prior to week selected, full amount is due.

Applications submitted 30 days or more before camp week chosen are eligible to pay deposit amount. You will receive a PayPal invoice for the balance due before your camp week start date. For applications submitted less than 30 days prior to week selected, full amount is due.

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

†Voucher code required; type below. Vouchers may only be used one time.

PAYMENT

Includes convenience fee of $3 for PreCamp and $6 for each full week. If you are paying the deposit, you will receive a PayPal invoice for the balance. You will only be charged one convenience fee for each week.

Robots cannot apply.