Youth Family Campout

Help us celebrate our younger 4 cabins by attending our Youth Family Campout at Camp Sweeney! Current or future campers age 14 and under along with their parents, or other guardians, are invited to come to camp for a day of F-U-N and a night under the stars! Siblings age 14 or younger are also invited to attend!

When? Saturday October, 7th at 11 AM to Sunday, October 8th at 10 AM

Where? Camp Sweeney

Cost? $25 per person

What do I bring? Attendees will be responsible for bringing their own tents (cabins will not be available), sleeping bags and pillows, campfire chairs, and diabetes supplies. A complete list of supplies and other details will be emailed after you have signed up for the overnight campout.

Questions? Email program1@campsweeney.org

SIGNUP

"*" indicates required fields

How many people are you registering? - $25 per person*

Number of total family members participating. Minimum is one adult and one camper.

Camper Name

Camper Name*

First Last

Age*

Parent/Guardian Name

If more than one parent/guardian is coming, please include put them as an additional participant.

Parent Name*

First Last

Additional Participant 1

Name*

First Last

Age*

Additional Participant 2

Name*

First Last

Age*

Additional Participant 3

Name*

First Last

Age*

Additional Participant 4

Name*

First Last

Age*

Additional Participant 5

Name*

First Last

Age*

Food Allergy

Do any of the listed participants require accommodations for food allergies?*

Food Allergy

Gluten Free

Dairy Free

Lactose Free

Vegetarian

Other

INDEMNITY AND RELEASE. PLEASE READ CAREFULLY.

I, the Parent/Guardian, on behalf of myself and my minor child(ren) who are listed above, understand that use of the Southwestern Diabetic Foundation and Camp Sweeney facilities and participation in facility programs and events creates a risk of injury and therefore expressly consent to and assume all risks associated with use of the Southwestern Diabetic Foundation and Camp Sweeney facilities and participation in their programs and events, even those which are not specifically foreseeable, and release, indemnify, defend, and hold harmless Southwestern Diabetic Foundation and Camp Sweeney and their directors, officers, employees, and agents (the “Released Parties”), from any loss, liability, claim, action, or suit (“Claim”) arising or alleged to arise from (A) bodily injury or personal injury suffered by any party on the Southwestern Diabetic Foundation and Camp Sweeney facilities, (B) bodily injury or personal injury caused by a participant in facility programs and events and/or (C) property damage or loss suffered in connection with, or as a result of, my or my minor child’s use of Southwestern Diabetic Foundation and Camp Sweeney facilities or participation in their programs and events, regardless of whether such claims and actions are founded in whole or in part upon alleged negligence of the Indemnified Parties. I, an adult person listed below, on behalf of myself and my minor child(ren) specifically and explicitly release, indemnify and hold harmless the Released Parties (defined above) from all liability, claims, demands, actions or rights of action, or damages of any kind including but not limited to those arising out of or relating to any one or more of the Released Parties’ own sole, contributory and/or comparative negligence. I knowingly and voluntarily release, indemnify and hold harmless the Released Parties from any such claims. I have read and understand the above waiver. This Indemnity and Release is made and is performable in Cooke County, Texas. I agree that exclusive venue for all claims arising from or related to this agreement, including claims for personal injury, lies in Cooke County, Texas. Pictures and video/audio recordings may be taken of the participants and staff on Youth Family Campout Weekend. I give the Southwestern Diabetic Foundation, Inc. permission to use the pictures and video/audio recordings of our family in any of its publicity campaigns and/or websites. We agree to abide by the behavioral rules and procedures set forth by Camp Sweeney for the safety of all participants and staff.

Acknowledgment*

I have read and agree to all the above releases and authorizations.

Parent/Guardian Name*

Payer Information

Payer/Cardholder's Name*

First Last

Payer/Cardholder Billing Street Address*

City*

State*

Zip Code*

Email*

A receipt will be sent to this address

Phone*

Coupon

Total Amount to be charged to your credit card today

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Date*