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XC in the Hills -- 2024 High School Summer Running Camp

Camp Nuhop - Hemlock Campus
5370 Bunkerhill North Rd, Butler, OH 44822

Starts: Sunday 21st of July 2024 at 1:00 pm
Ends: Wednesday 24th of July 2024 at 4:00 pm (EST)

XC in the Hills -- 2024 High School Summer Running Camp

XC in the Hills -- Early Registration - Registration Form

Camper's First Name*

Camper's Last Name*

Email Address*

This should be the email address where you want all camp correspondence sent

Camper's Cell Phone*

Camper's Home Address*

Street Address:

Postal Code:

e.g. "90210" or "V0E 2S0"

City:

State/Province:

Postal Code:

Country:

Gender*

Age During Camp*

Camp dates are July 21-24, 2024

Birthdate*

High School Name*

Grade being entered in Fall 24'*

Tshirt Size*

Shirts are Unisex Sizing

Have you attended this camp in the past?*

Recent 5k PR*

This Information will be used to put you into an appropriate group for group runs, please answer as accurately as possible.

Please Note any Dietary Restrictions*

Emergency Contact Name*

Emergency contact must be 18 years or older. We will contact this person in the case of emergency.

Emergency Contact Home Address *

Street Address:

Postal Code:

e.g. "90210" or "V0E 2S0"

City:

State/Province:

Postal Code:

Country:

Emergency Contact Cell Phone*

Family Physician Name*

Family Physician Phone Number*

Health Insurance Provider's Name*

Health Insurance Policy Number*

Current Medical Conditions the Camp Staff should be aware of?*

If NONE, type "NONE"

Any Allergies the Camp Staff should be aware of? *

If NONE, type "NONE"

Are you currently taking any Medications that the Camp Staff should be aware of?*

If NONE, type "NONE"

Medical Consent Waiver*

This Waiver must be signed by an adult 18 or over which in many cases could be your parent or legal guardian If the Camper sustains an injury or illness and if Campers lacks the legal capacity due to age or otherwise to make an informed decision regarding his or her medical care I hereby consent to such emergency medical treatment as is deemed necessary and prudent by a licensed medical professional or Camp Staff Member until such time as Camper becomes available and legally capable of making such a decision or until an Emergency Contact person designated above can be reached in order to make such a decision.

I have read and agree to the terms above.

Electronic Signature of Legal Liability Release Waiver*

By clicking below I am verifying that I am Camper who is 18 years or older or the parentlegal guardian of a Camper under 18 years of age.

I have read and agree to the terms above.

Legal Liability Release Waiver*

I the undersigned acting as participant or parentguardian of the participant agree to abide by any decisions of the camp director relative to safely completing the camp. I assume all risks associated in attending this camp including but not limited to falls contact with other participants the effects of the weather traffic and the conditions of the terrain all such risks being known and approved by me. Having read this waiver and knowing these facts and in consideration of you accepting my entry I for myself and anyone entitled to act in my behalf waive and release XC in the Hills High School Running Camp Fleet Feet Mid Ohio Mid Ohio Race Management Camp nuhop Legacy Springs Camp Faith Life Church Brian Polen and Matt Suttle and all sponsors their representatives and successors from all claims of liability of any kind arising out of my participation in this Event. I also understand that there are fixed costs associated to my registration and XC in the Hills has a no refund policy. The camp organizers reserve the right to cancel the event due to unforeseen circumstances such as weather and other natural disasters. I hereby grant full permission to any or all of the foregoing to use any photographs video tapes motion pictures recordings or and other record of this event for any legitimate purpose. I also understand that XC in the Hills is a camp that I am attending voluntarily to tune my skills for the upcoming XC season and foul language insubordination and failure to conform to the rules of the camp could lead to my early dismissal without refund. There will be a no-nonsense policy regarding bullying and all Campers will be held strictly to that policy.

I have read and agree to the terms above.

Ticket Type: XC in the Hills -- Early Registration
Ticket Information: Includes entry into the XC in the Hills High School Running Camp, $50 gift certificate redeemable at Fleet Feet Mid Ohio Locations, Official Camp T-shirt, lodging/meals for 4 days/3 nights, and much more!

Ticket Price: $285.00
Total After Fees : $296.80

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