Forms & Registration | Shady Trails Camp

Please use the form below to register for Shady Trails Camp!

2023 Sessions

Week 1  July 3  - July 7  $288*
Week 2  Week 2 is FULL!
Week 3  Week 3 is FULL!
Week 4  Week 4 is FULL!
Week 5  July 31 - Aug 4   $360

Fees: $360 per week, per camper, lunch & snacks provided daily.

*Week 1 is only 4 days due to 4th of July. Price has been reduced accordingly.

Your Name & Relation to Camper*
Email Address*
Camper Information
Camper's Full Name*
Is your child a first-time camper?*
- Yes
- No
Age During Camp*
Date of Birth*
Fall 2023 Entering Grade*
Emotional or Physical Special Needs, Limitations, and Required Adaptations
Winter Home Mailing Address*
Winter Phone Number*
Summer Home Mailing Address (or type "Same")*
Summer Phone Number*
Summer Email Address*
Emergency Contact Information
Your primary or secondary emergency contact MUST be able to pick up your camper during camp hours.
Primary Emergency Contact Name & Phone*
Secondary Emergency Contact Name & Phone*
People to whom camper may be released (other than Parent/Guardian)*
Sessions
Please check the week(s) your child/children will be attending: ALL SNACKS AND LUNCHES ARE INCLUDED

NOTE: Week 1 is only 4 days due to 4th of July
Week 2 (July 10 - July 14), Week 3 (July 17-21) & Week 4 (July 24-28) are now FULL
Select Session(s)*
- Week 1 July 3 - July 7 $288*
- Week 5 July 31 - Aug 4 $360
Send a non-refundable deposit of $100 per camper upon submission of this form to:
Shady Trails Camp
6880 N. Shady Trails
Northport, Michigan 49670

To ensure a placement at camp, balance is due June 23, 2023. You may also pay in full.

Shady Trails Camp complies with all State of Michigan licensing requirements. Shady Trails Camp admits campers of any race, religion, national or ethnic origin.
Health Care Authorization Statement
I hereby give permission to Shady Trails Camp, which is licensed by the State of Michigan, to provide routine, non-surgical medical care, and to secure emergency medical and surgical treatment, for the camper named above, while attending camp. I understand that I will be contacted in case of sickness, accident, or emergency. If I cannot be contacted in case of an emergency, I give permission to the physician for treatment or tests to the above names child as he/she deems necessary.
Type "I AGREE" in lieu of Parent/Guardian Signature*
In accordance with MCLA Act 116 of the Public Acts of 1973, as amended, and the rules for licensing camps, this authorization must be signed by a parent or guardian of a child camper unless there is religious objection.

On behalf of my child, I hereby waive and release, hold harmless, and forever discharge Shady Trails Camp and its employees of and from any and all claims arising from or in any way related to my child’s allergies or allergic reactions. I understand that the activities, food, and drink that my child may partake in may be inherently dangerous and may cause serious allergic reactions.
My child is subject to the following allergies or medical conditions listed below.
Health Conditions
I understand that Shady Trails Camp has “Health Officers”, but a medical professional may be contacted in an event of an allergic reaction, accident, or emergency. In the event that my child should require medical care while attending Shady Trails Camp, I authorize the facility, Shady Trails Camp and said employees, to disclose these conditions to a physician or other medical professional in the event my child should require emergency medical care. By this waiver, I, on behalf of my child, release and waive all responsibilities and claims of personal allergic injury or accident while on the premises and taking part in Shady Trails Camp activities. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law.

Does your child have a history of any of the following? Please check all that apply:
Conditions
- Allergies
- Asthma
- Back Ailments
- Diabetes
- Epilepsy/Convulsions/Seizures
- Fainting
- Frequent Ear Infections
- High Blood Pressure
- Surgeries
Any medication must be administered by a parent or guardian, please make arrangements with the director prior to camp.
Medications Currently Taking (Please list)
Immunizations
Covid*
Enter date your child received the following immunizations or "NONE":
Measles*
Polio*
Rubella*
Mumps*
Last tetanus shot (*)*
(*) *Preferably within the past five (5) years
Parent/Guardian Electronic Signature For Above Health Information (Type "I AGREE"):*
Challenge Ropes Course Informed Consent/Liability Release
*Only for campers 10 years and older

I am aware and understand that participation in a challenge course program is physically challenging and potentially dangerous and involves the potential risk of serious physical injury. I agree and hereby acknowledge that I am solely responsible for my participation and for compliance with all risk management and course operation policies, along with my own physical and emotional well-being. I further acknowledge that while at the activity site I will not be under the influence of any substances, including alcohol. I willingly and knowingly assume for myself, my heirs, family members, executors, administrators and assign all risk of physical injury and emotional upset which may occur during or after participating in this event and hereby agree to hold Shady Trails Camp, its employees, its instructors, its associates and agents harmless for liability arising out of my participation in the program. I understand that participation on the ropes course is at the discretion of the Shady Trails Camp ropes facilitator and is dependent upon age and size–weight and height.
Camper Electronic Signature* (Type "I AGREE"):*
Parent/Guardian Electronic Signature (Type "I AGREE"):*
Release For Electronically Displayed Or Printed Photos Of Camp Attendees
We would like to use your son/daughter’s photo on our web page and/or printed media. Names, telephone numbers, home address or other identifying information will not be displayed or made available.
I hereby (please check):*
- Give
- Do Not Give
Permission and consent for digital and or printed photos of my son/daughter to appear on the Shady Trails Camp web site and printed media.
Parent/Guardian Electronic Signature For Photos (Type "I AGREE" for your choice):*
Authorized Person Permission
I understand and certify that my child’s participation in Shady Trails Camp and its activities is completely voluntary, and I have completely familiarized myself with the camp’s programs and activities in which my child will be participating. I recognize that certain hazards and dangers are inherent in Shady Trails Camp events and programs and particularly, but not limited to, the activities of swimming, canoeing, rope course, kayaking, and ball and racquet sports. I acknowledge that, although Shady Trails Camp has taken safety measures to minimize the risk of injury to camp participants, Shady Trails Camp cannot insure nor guarantee that the participants, equipment, premises and/or activities will be free of hazards, accidents and/or injuries. I further recognize and have instructed my child in the importance of knowing and abiding by the camp’s rules, regulations, and procedures for the safety of camp participants.
Type Name of Authorized Person, Relationship to Camper and Date as Your Agreement:*

2023 Sessions

Camper Information

Emergency Contact Information

Sessions

Health Care Authorization Statement

My child is subject to the following allergies or medical conditions listed below.

Immunizations

Challenge Ropes Course Informed Consent/Liability Release

Release For Electronically Displayed Or Printed Photos Of Camp Attendees

Authorized Person Permission