Registration for:

Campers, Jr. Leadership, Leadership & Volunteers


Camper's Name (required)

Camper's Birthdate (required)

Camp Type (required)

Please list any of the camper's dietary restrictions

Parent/Guardian's Name (required)

Address (required)

Address 2

City (required)

State/Province (required)

Zip/Postal Code (required)

Parent/Guardian's Telephone (required)


Parent/Guardian's Telephone 2


Email (required)

Emergency Contact Information:

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number


General Release & Parental Consent

I hereby release and discharge the WindRiders Adventure Camp, Bit-O-Wyo Ranch, Christopher Keener and Heather Steele, Dennis Steele, Molly Meyer and/or any person affiliated in any manner therewith from any claims, actions, demands, rights, damages, costs, controversies of any kind, known or unknown, including but not limited to those connected with or arising out of any association I or anyone who is affiliated with me may have, have had, or will have with WindRiders Adventure Camp. In the event your child is sent home due to inappropriate behavior or violence no refund is available. WindRiders has a strict harmlessness policy. By signing this release form you understand that your child may be photographed and video taped at WindRiders Camp and said photos may be used for Camp marketing in the future. The undersigned has read the foregoing General Release, understands it, agrees to be bound by it, shall indemnify, save and hold harmless WindRiders and further attests that the following signature is his/her legal name and signature. Furthermore, As a parent of the above named minor applicant, I hereby give my permission for him/her to participate At Windriders Adventure Camp indicated on this enrollment form. Your typed name shall be considered equivalent to a signature on a paper form.

Signature/Date Required:

Signature (required)

Date (required)

Please complete the verification below: