JOIN US IN 2017!

Please complete the Camp Registration Form below and submit your payment. This is a two-step process and your application will not be complete without payment or indication or how payment will be made.  If you have any questions regarding our camp, please contact us. If you would like to request a full or partial scholarship, please fill out the Scholarship Application. Please do not fill out both forms. 

Parent/Guardian Full Name *
Parent/Guardian Full Name
Mailing Address *
Mailing Address
Cell Phone *
Cell Phone
Home/Alternate Phone *
Home/Alternate Phone
If different from Parent/Guardian. Please include full name, relation to camper, and cell phone number.
Camper's Full Name *
Camper's Full Name
T-shirts are adult size.
Which camp will your child attend? *
Please describe
Please tell us a few of your interests such as archery, hiking, fly fishing, cast iron cooking, plants, photography, orienteering, weed identification, first aid or any other outdoor activity.
The Camp Fee is $250 per camper. If you are interested in a full or partial scholarship, please complete the scholarship application. *
IF YOU ARE INTERESTED IN A FULL OR PARTIAL SCHOLARSHIP, PLEASE RETURN TO THE PREVIOUS PAGE AND COMPLETE THE SCHOLARSHIP APPLICATION.
The undersigned Parent or legal Guardian agrees to to the terms of this waiver and release of liability (“Agreement”), including the general waiver and release of liability described below and agree to be bound by the following: Identification of Risks: I fully understand that my child’s participation in or observation of the Activity means that my child will be in an outdoor setting as an integral part of participation in the Activity. My child may be participating in or observing activities including, but not limited to: archery, hiking, biking, climbing, fly-fishing, horseback riding, horse safety and care, wildlife identification and tracking, on‐site water sampling of creeks and lakes, plant identification and natural history, geology education, terrain navigation, wilderness survival skills, art, astronomy. Any of these Activities may, by their nature, expose my child to a variety of known inherent risks and dangers, including the inherent risk of serious bodily injuries, death and property damage, which injuries and damage could arise out of his or her own actions or inactions, those others participating in the Activity, the weather or other conditions in which the Activity takes place, his or her health conditions, the structure or maintenance of any facilities used in connection with the Activity and equipment used in connection with the Activity. I also fully understand that all risks are not apparent, knowable or foreseeable. I acknowledge that use of protective equipment such as helmets and life jackets have benefits that may reduce or mitigate the severity of injuries to my child, but use of protective equipment is not a guarantee of safety. Assumption of Risk: I hereby knowingly and voluntarily assume all risks, known and unknown, relating to the Activity, including the risks of serious bodily injuries such as permanent disability, paralysis or death and agree to be responsible for any and all injuries, damages, costs, expenses and other losses that could arise at any time as a direct or indirect result of my child’s participation in or observation of the Activity. Waiver and Indemnification: Aware of the risk and willing to assume them, I for my child, myself, my heirs, executors, administrators, legal representatives, assigns and successors in interest (“Representatives”), to the fullest extent permitted by law, hereby release to the fullest extent permitted by law, hereby release Jack Creek Preserve Foundation, and each of its affiliated or parent companies, subsidiaries, officers, directors, members, managers, employees, agents, guides, trainers, doctors, officials, organizers, concessionaires, volunteers or sponsors ( collectively, the “Released Parties” or “Providers”) from any and all claims by me, my child, or my Representatives in any way connected with my child’s preparation for and/or participation in or observation of the Activity, both in law and in equity, in any way arising out of or resulting from damage to property or personal injury, conscious suffering, or death sustained by me, my Representatives or my child. Release from liability includes loss, damage, or injury resulting from intentional acts, failure to act, negligence, or any other cause or causes; except where caused by the gross negligence or willful or wanton misconduct of any of the Released Parties. This waiver and release shall bind me, my Representatives, my child any and all relatives, personal representatives, heirs, beneficiaries, next of kin, subrogees or assigns who might pursue any legal action or claim on my child’s behalf. I on behalf of myself, my Representatives and my child further agree that I WILL DEFEND, INDEMNIFY AND HOLD HARMLESS the Released Parties against all claims, demands and causes of action, including court costs and reasonable attorneys' fees, directly or indirectly arising from any action or other proceeding brought by or prosecuted contrary to this Agreement for the benefit of me or my child. This Agreement extends to all claims of every kind and nature whatsoever, whether known or unknown. Emergency Medical Care: I verify that my child has no past or current physical condition that might affect their participation in Activity. In the event my child is in need of emergency medical treatment, I hereby authorize any medical care provider to carry out first aid or any emergency medical care and I accept responsibility and agree to indemnify the Released Parties for all such medical care and expenses. Applicable Law: This waiver and release shall be governed by Montana Law and exclusive jurisdiction for any such claims shall be in State District Court in Madison County, Montana, or in a Federal District Court in Montana. Severability: A determination of invalidity of any one or more of the provisions or conditions hereof by judgment, order or decree of a court shall not affect in any manner the other provisions hereof which shall remain in full force and effect. THIS AGREEMENT SHALL BE EFFECTIVE UNTIL TERMINATED IN WRITING BY JACK CREEK PRESERVE FOUNDATION. *
Please check the box below to agree to our Waiver and Indemnification
During Jack Creek Preserve Foundation events, photos or videos of attending youth are often taken for use in promotional materials for the Preserve. Neither your childs name nor any other identifying information will be made available in any way.The Jack Creek Preserve Foundation is currently hosting a Montana Conservation Corps (MCC) member as a part of their staff. Therefore, photo and video media taken at the Jack Creek Preserve may be shared with the Montana Conservation Corps.The participant and guardian do hereby give full consent to both the Jack Creek Preserve Foundation as well as the Montana Conservation Corps to copyright or publish all videos and photographs in which the participant may appear. The participant and guardian do hereby understand that MCC is a highly visible program within the community and media eye, and hereby give consent for release of all video and photographic materials and waive any right to inspect or approve of the finished product. *
Please check the box below to give photography permission
2017 SUMMER YOUTH CAMP REGISTRATION FEE
250.00
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