To Register for the 2019 Liberty Camp Geauga please use the following form.  Alternatively if you would like to use a paper form click HERE to print a PDF form and  email the form to admin@libertycampgeauga.com or mail it to : P.O. Box 250 Russell Ohio 44072.   If you are mailing your form please attach the payment.  If you email the form please send payment within 7 days.  

Note: Registration cost is $50 per camper.

CAMPER REGISTRATION

Parental/Guardian Information


EMERGENCY CONTACT INFORMATION

PHOTO AND VIDEO RELEASE FORM

I hereby authorize the Liberty Camp Geauga 2019 and the Liberty Camp Geauga staff to use, reproduce and/or publish all written and/or visual materials, including photographs and video that may pertain to me or my children. I understand that this material may be used in various publications, public affair releases, recruitment materials, or for other related endeavors. This material may also appear in newspapers or on the Liberty Camp Geauga website. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. Consequently, Liberty Camp Geauga 2019 and the Liberty Camp Geauga staff may publish materials, photographs, video and/or make reference to same in any manner that is deemed appropriate in order to promote/publicize the event/program.

You will be asked for a signature confirming your agreement with the statement on the day of registration.


LIABILITY WAIVER

As the parent/guardian checking "I agree" constitutes your legal waiver as written. All registrants MUST HAVE a signed liability waiver to attend the Libety Camp Geauga 2019.

I certify that I have adequate accident insurance and I will not hold the Liberty Camp Geauga, its leaders, Staff, or Volunteers liable for any and all claims related to participation in this program.


CAMPER INFORMATION


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