CAMPER *

First Name

Last Name

CAMPER CODE OF CONDUCT *

In order to maintain a safe camp, everyone who attends Girls Rock MKE must read and sign the Code of Conduct agreement. Be supportive of one another, especially in regard to individual musical abilities and creative efforts. Be supportive of respectful of yourself in regards to your own abilities and creative efforts. Be respectful of all staff members, campers, students and guests. Respect all the instruments, equipment, and property and treat them with care. Turn off all cell phones, iPhones, IPads, iPods and any other electronic devices during camp programming unless given special permission to use by the instructor. Always respect each other’s differences in race, ethnicity, religion, ability, size, politics, sexual orientation, veteran status, economic status and identity. No foul or offensive language. No violence of any kind. No bullying, name calling, or mean-spirited behavior. No drug or alcohol consumption or possession on Rock Camp premises. No smoking on Rock Camp premises.

By checking this box, the Camper listed above agrees to abide by these guidelines and understands that any violation of these guidelines can lead to suspension or expulsion from Girls Rock MKE without refund of tuition.

PARENT/GUARDIAN *

I have read and understood the Girls Rock Camper Code of Conduct and Camp Handbook and agree to abide by its rules and regulations. I understand that the handbook is subject to change, and I will comply with any updates or revisions. By signing below, I acknowledge that I have reviewed the Code of Conduct and Camper Handbook with my child and we both understand and agree to comply with its terms.

First Name

Last Name

DATE *

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CAMPER *

First Name

Last Name

PARENT/GUARDIAN RELEASE FORM FOR MEDIA RECORDING *

This form grants permission to Girls Rock MKE, Inc. to use the image of my child (identified as "Camper" listed above). Use includes display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Girls Rock MKE website and social media pages. I give unrestricted permission for my child’s image to be used in video, print, and digital media. I agree that these images may be used by Girls Rock MKE for a variety of purposes and that these images may be used without further notifying me. I do understand that the child’s last name will not be used in conjunction with any video or digital images.

By checking this box, the parent/guardian listed below, grantS permission to Girls Rock MKE, Inc. to use the image their child (listed as "Camper" above).

PARENT/GUARDIAN *

First Name

Last Name

DATE *

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DD

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CAMPER *

First Name

Last Name

CONSENT TO MEDICAL TREATMENT & RELEASE OF LIABILITY *

In consideration of being allowed to participate in Girls Rock MKE related events and activities, I hereby Release, Waive, Discharge and Covenant Not to Sue Girls Rock MKE, their officers, servants, agents, employees, this camp and its employees or volunteers, and Directors (hereinafter referred to as Releasee) from any and all liability, claims, demands, or course of action whatsoever arising out of or relating to any loss, damage, or injury, including death that may be sustained by me/my child, or to any property belonging to me/my child, whether caused by the negligence of the release, or otherwise, while participating in this camp, or while in, on or upon the premises where the camp is being conducted. To the best of my knowledge, my child is in good physical condition and I am not aware of any physical infirmity, which would place my child at risk to participate in any way with camp activities. I am fully aware of the risks and hazards connected with Girls Rock MKE. I voluntarily assume full responsibility of any risk of loss, property damage or personal injury including death that may be sustained by my child or any loss or damage to property owned by me/my child, as a result of being engaged in camp activities, whether caused by the negligence of the release or otherwise. I further herby agree to indemnify and hold harmless the release from any loss, liability, damage or cost, including court costs and attorney’s fees that may accrue related to me/my child’s participation in this camp. During the period of camp, I hereby give permission for the staff of Girls Rock MKE to administer appropriate medical attention to my child in the event of an accident, illness or injury. I will be responsible for any and all costs of medical coverage and treatment provided not covered by insurance. It is my express intent that this waiver of liability and hold harmless agreement shall bind the members of my family and spouse, if I am alive and my heirs, assigns personal representative, if I am deceased, and shall be deemed as a release, waiver, discharge, and covenant not to sue the above named Releasee, I hereby further agree that this waiver of liability and hold harmless agreement shall be construed in accordance with the laws of the State of Wisconsin. In signing this release, I acknowledge and represent that I have read and understand It and sign it voluntarily; I am at least 18 years of age and fully competent; and I execute this release for full, adequate, and complete consideration fully intending to be bound by the same.

By checking this box, the parent/guardian listed below, have read and agree to this waiver of liability and sign it freely and voluntarily without inducement.

PARENT/GUARDIAN *

First Name

Last Name

DATE *

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CAMPER *

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Last Name

PICK UP CONTACT #1 *

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Last Name

PICK UP CONTACT #1 PHONE *

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PICK UP CONTACT #2

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PICK UP CONTACT #3

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PICK UP CONTACT #3 PHONE

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NAME (PRIMARY) *

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PHONE (PRIMARY) *

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NAME (ALTERNATE)

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