It's Summer Camp time! 

The 2017 session of Camp Jamison will be held July 17th through the 21st  

A $100 deposit is needed to hold all campers' spots. 

This fee is non-refundable. 

Apply and pay the deposit before January 1, 2017 and receive a $10 discount!



July 17 - 21, 2017
June 2, 2017 12:01am [Eastern Time]
INFO:   Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable. You may choose alternate options or join the waiting list.

Review Your Payment Information:

Registrant Fee: $0.00



Billing information


Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*CAMPJAMISON 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
Please enter your full name in the space below.
 


Please click the button below to finalize your registration.



Registration inquiries:
Nicole Shirk
Nshirk@campjamisoncorp.org
(215) 990-4460
= required field
Oops! You do not have javascript enabled. This registration process depends on javascript to function correctly.

Please enable javascript in your browser and then reload this page.
Registrant   remove this registrant


Camper Information


Guardian Information


Income Information (To be kept confidential)


Camper Medical History
This information is used to help campers have a safe and fun experience, not to exclude anyone.

Asthma
Constipation
Diarrhea
Bedwetting
Sleep Problems
Frequent Stomach Aches
Frequent Headaches
Vision Loss
Hearing Loss
Depression
Anxiety
OC Behaviors
Other
None of the above
Wheelchair
Walker/ Crutches
Split/ Brace
Contact Lenses
Glasses
Other
None of the above

Please note:  Swimming at Camp Jamison takes place under the supervision of highly trained lifguards and instructors.  No child is ever left unsupervised or alone in or near the water.


For female campers


School Information
This information is used to help campers have a safe and fun experience, not to exclude anyone.

Physical Therapy
Ocupational Therapy
Speech Therapy
Extra Counseling
None of the above
Internet Search
Flyer from School
Craigslist
Other
Current Camper Referral
PARENT/ GUARDIAN CONSENT FORM

Permission to Secure Treatment

In the event of any emergency, I authorize the Camp Jamison Corporation to secure from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for me or my minor child/ward's immediate care and agree that I will be responsible for payment of any and all medical services rendered. I understand that this authorization includes transporting my child by ambulance if necessary to the nearest medical treatment facility or hospital if I am unable to be reached first.


CONSENT FOR MEDICAL TREATMENT

I, the undersigned parent/guardian hereby grant permission to the medical staff or consulting physician at Camp Jamison. to administer medications and provide medical care for the attending camper. I also give consent for any emergency transportation deemed necessary. I understand that all attempts will be made to reach an emergency contact or me before any action is taken. If no contact is available, the decision to treat my child will be made by the camp director. I also understand that Camp Jamison will treat all information pertaining to my child as confidential, however, I agree that said information may be shared with /released to appropriate personnel and/or third parties for the purpose of treating and/or supervising my child.

This health history is correct and accurately reflects the health status of the camper to whom it pertains. The person described has permission to participate in all camp activities except as noted by me and/or an examining physician. I give permission to the physician selected by the camp to order x-rays, routine tests, and treatment related to the health of my child for both routine health care and in emergency situations. If I cannot be reached in an emergency, I give my permission to the physician to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for this child. I understand the information on this form will be shared on a “need to know” basis with camp staff. I give permission to photocopy this form. In addition, the camp has permission to obtain a copy of my child’s health record from providers who treat my child and these providers may talk with the program’s staff about my child’s health status.

ASSUMPTION OF RISK

I understand that part of the camping experience involves activities and group living arrangements and interactions that may be new to my child, and that they come with certain risks and uncertainties beyond what my child may be used to dealing with at home. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free, and so I have instructed my child on the importance of abiding by the camp’s rules, and my child and I both agree that he or she is familiar with these rules and will obey them.


RELEASE OF LIABILITY

In consideration of the opportunity afforded my child to participate on a voluntary basis in the Camp Jamison program organized by Camp Jamison Corporation. I hereby waive any right or cause of action arising as a result of my child’s participation in said camp program from which any liability may or could occur against Camp Jamison Corporation. or its officers, directors, agents, employees, donors and/or volunteers, either collectively or individually.


PHOTO RELEASE

I hereby grant to Camp Jamison Corporation and assigns the right to photograph my dependent and use the photo and or other digital reproduction of him/her or other reproduction of his/her physical likeness for publication processes, whether electronic, print, digital or electronic publishing via the Internet.
Check this box to indicate that you have read and agree to all of the above terms & conditions