Highland Scout Camp 2011
North America's best summer camp and training event for youth and adults
HIGHLAND - Of the mountains; a landscape characterized by high altitudes, temperate forests, fields, abundant natural resources and associated wildlife.
SCOUT - Any person who can adapt to a changing environment, survive and thrive, who derives confidence from an artful level of skill in wilderness, and who can navigate unseen through harsh terrain by acknowledging a spiritual connection to the world around them.
_____________________________________________________________________________
Please copy/paste and print the following form for complete registration
or CLICK HERE for a .doc / microsoft word version
Liability Form
Students at Land of the Sky Wilderness/Martial Arts can expect rigorous physical and mental training. Participation in class may include but is not limited to activities requiring extended periods of exertion, elevated heart rate, stretching, kicking, falling, and hitting target pads with full force. Students participating in free fighting activities engage in simulated combat and self-defense scenarios which can lead to serious injury including paralysis and death. Free fighting, while not intended to be full force, can lead to hits, strikes, and grapples against sensitive areas of the body including the head. While our school has an outstanding safety record all students and parents are hereby notified of such risks and by signing below surrender the right to hold liable the following parties; Land of the Sky Wilderness School LLC, Spencer Bolejack, Black Mountain Parks and Recreation, the Carver Center, any assistant instructors or students.
In addition, Highland Scout Camp includes activities and functions which increase the risk factor for students. Students learn about poisonous and edible plants, are exposed to the elements, and use hazardous tools including but not limited to saws, knives, firearms, hammers, sewing needles, bows and arrows, red hot metal around the blacksmithing forge, and are around unpredictable animals such as horses, birds of prey, wolves, and dogs. Students are given ample instruction with every tool before using and tool use is incremental resulting in more individual responsibility over time. However, unexpected events are part of the farm and wilderness environments. Therefore, by signing below, parents, legal guardians, or students over the age of 18 years, acknowledge all activities are voluntary, participation may be declined at any time, and that the aforementioned parties are not liable for any civil or medical grievances.
Furthermore, the director has been informed in writing of ANY medical requirements, special needs, injuries, allergies, or medications acquired, held, or needed by the student whose name is printed below. You acknowledge that you are over 18 years of age, or are the parent/legal guardian for said student.
Student Name (printed):_____________________________________________________
Parent/Guardian (Printed, if student is under 18):____________________________________
Special Needs or injuries:____________________________________________________
_________________________________________________________________________________
I, __________________________________________, being over the age of 18 or being the parent/guardian of said minor, agree to the contract as stated and hereby give full authority for professional emergency medical treatment in the event that camp staff deem such treatment necessary for the safety and well being of myself or the child in question. I furthermore agree that camp director Spencer Bolejack has had adequate experience and training for general camp security and safety and trust his judgment in such matters.
Date:__________________________________________
Insurance company, #, and policy holder if applicable:_________________________________________________________________
Emergency name, Phone #, and relation:______________________________________________________________________________
YOUR contact info and relation (email, phone, address) ________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Additional information regarding social issues, personality, background and experience, that you would like us to know, please attach more paper as necessary! A photo for new students is great too so we can start learning names before someone arrives.
Scout Camp main page
__________________________________________________________
Land of the Sky martial Arts
______________________________________________________