Mt Tam Bikes Camp 2024 Summer Camp Registration

(This Form is Private and Secure)

Camper/Child Information

Child's First Name *

Child's Last Name *

Camper Date of Birth. Select on Calendar or enter accordingly (MM/DD/YYYY) Camp is for Ages 8-14. * +

Camper Preferred Gender Pronouns *

He/Him	She/Her
They/Them	Other Other

School (in Fall) *

Grade (in Fall) *

Camper T-Shirt Size *

Camper/Child Home Information

Home Street Address *

City *

State *

Zip Code *

Home Phone #

Camper/Child Riding Ability

PLEASE READ: Our goal is to provide all of our campers with a safe, fun and developmentally appropriate riding experience. To help accomplish this, we try to accurately assess each camper’s ability in advance to assist in creating balanced groups of riders that have similar ability. If you are registering with friends that have different riding abilities but want to ride together, please select the ability of the least experienced rider.

IF YOU ARE UNSURE OF YOUR CAMPER'S RIDING ABILITY, PLEASE CONTACT US.

Please select one: *

NOVICE RIDERS are already comfortable controlling their bikes with the ability to start, stop, turn and ride in a controlled manner for 2-5 miles, climbing up and descending down small hills without constant breaks. Example of a Novice Ride: Slowly riding the Shoreline Trail at China Camp without constantly stopping for breaks. Riding from Downtown Mill Valley to Sausalito on streets and paths without constantly stopping for breaks. If your camper is still working on riding in a controlled manner, they are not ready for camp yet!

INTERMEDIATE RIDERS Intermediate riders are already confident in controlling their bikes up and down hills, slowly climbing moderate hills without breaks, and are able to comfortably ride for 5-10 miles on dirt. Example of an Intermediate Ride: Slowly riding up the Old Railroad Grade from its start in Mill Valley to West Point Inn without constantly stopping for breaks. Steadily riding the Shoreline Trail at China Camp with a few breaks.

ADVANCED INTERMEDIATE RIDERS Advanced Intermediate Riders are confidently riding their bikes on moderate technical terrain, steadily climbing bigger hills without constant breaks and able to comfortably ride for 10-15 miles on dirt. Examples of an Advanced Intermediate Ride: Steadily riding up the Old Railroad Grade from its start in Mill Valley to East Peak. Steadily riding the Bay View China Camp loop or riding Camp Tamarancho.

ADVANCED RIDERS Advanced Riders are confidently riding their bikes on technical terrain, steadily climbing bigger hills with minimal breaks and able to comfortably ride for 15-20 miles on dirt. Examples of Advanced Rides: Steadily riding up the Old Railroad Grade from its start in Mill Valley to West Point Inn and then onto Coastal View trail to Muir Beach and then up Middle Green Gulch trail or Diaz Ridge. Steadily riding the Bay View China Camp loop and Camp Tamarancho would be an Advanced Ride.

2024 Summer Sessions

SELECT PAYMENT METHOD: *

SPACES DO OPEN UP. PLEASE CLICK HERE TO WAIT-LIST IF YOUR PREFERRED SESSION/GROUP IS FULL (0 remaining) = FULL

$650 per Session ($20 Discount for Payment by Check)
*

Session 01 June 17 - 21 (1 remaining)

Session 02 June 24 - 28 (0 remaining)

Session 03 July 8 - 12 (1 remaining)

Session 04 July 15 - 19 (1 remaining)

Session 05 July 22 - 26 (4 remaining)

Session 06 July 29 - August 2 (6 remaining)

Session 07 August 5 - 9 (8 remaining)

Session 08 August 12 - 16 (5 remaining)

Parent/Guardian 1 Will Be The Primary Contact For All Camp Communication

Parent/Guardian 1 First Name *

Parent/Guardian 1 Last Name *

Parent/Guardian 1 Cell Phone # *

Parent/Guardian 1 Work/Office #

Parent/Guardian 1 Email Address *

Please re-enter email address *

Parent/Guardian 2 Information (not required)

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Mobile/Cell Phone #

Parent/Guardian 2 Work/Office #

Parent/Guardian 2 Email Address

Please re-enter email address

Emergency Contact (PLEASE DO NOT LIST PARENTS) In the event of an emergency we contact parents first.

PLEASE DO NOT LIST PARENTS. We will contact parents first in the event of an emergency.

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Mobile/Cell Phone # *

Emergency Contact Work/Office #

Child/Camper Health Information

Does the participant have health insurance? (Campers must have Health Insurance to participate) *

Yes

No

Does the participant take any medications? *

Yes

No

Please list ALL medications (including over-the-counter or non-prescription drugs) taken routinely. Bring enough medication to last the entire time at camp. Keep it in the original packaging/bottle that identifies the prescribing physician (if a prescription drug), the name of the medication, the dosage, and the frequency of administration.

List Medications *

List of all known allergies and/or conditions

Authorized Pick Up List

The following people have my complete permission to pick up my child(ren) at anytime, from Mt Tam Bikes Camp. (PLEASE DO NOT LIST PARENTS). *

+-

Misc. Information

Additional Comments/ Notes to the Camp Staff
Please feel free to list anything here that may help us get to know your camper better.

Where have you heard about us? *

General Release / Waiver "Conditions of Enrollment"

Mt Tam Bikes Camp Waiver

MT TAM BIKES CAMP - RELEASE OF LIABILITY, WAIVER AND ASSUMPTION OF RISK AGREEMENT. PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. CYCLING ON AND OFF-ROAD AND MOUNTAIN BIKING IS AN ATHLETIC ACTIVITY, THE PARTICIPATION IN WHICH INVOLVES VARIOUS RISKS. PLEASE THOROUGHLY READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING.

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. Evidence has shown that COVID-19 can cause serious and potentially life-threatening illness and even death.

While we will follow all national and local guidelines to slow the spread of COVID-19. Mt Tam Bikes Camp cannot prevent you and your child(ren) from becoming exposed to, contracting, or spreading COVID-19 while utilizing Mt Tam Bikes Camp’s services. It is not possible to prevent the presence of the disease. Therefore, if you choose to utilize Mt Tam Bikes Camp’s services you are increasing your and your child(ren) risk of contracting or spreading COVID-19.

ASSUMPTION OF RISK COVID 19: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my child(ren) in order to utilize Mt Tam Bikes Camp’s services. These services are of such value to me and to my child(ren), that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize Mt Tam Bikes Camp’s services.

ASSUMPTION OF RISK CYCLING ON AND OFF-ROAD AND MOUNTAIN BIKING: Cycling on and off-road and Mountain biking takes place on cement and dirt roads with motor vehicle traffic, paths and trails. Cycling on and off-road and Mountain Biking may take place on steep, rugged and challenging terrain and features, and will expose the rider to many risks, dangers and hazards. Falls and collisions occur frequently. Bicycles and related equipment may be placed under extreme stress and can malfunction. Helmets and Gloves are mandatory. As with many adventure sports, riding involves the risk of injury, including serious injury, head injury, paralysis or death. The risk of injury increases with the degree of difficulty of the terrain, trail and speed. Although the risk of injury can never be eliminated, the rider can manage the risk through controlling speed and choosing terrain appropriate for the rider’s skill and experience. What features and sections of trail that the rider chooses to ride is always at the discretion of the rider, not the mountain bike instructor or coach, or anyone else. RIDERS CAN CHOOSE TO WALK THEIR BIKES AT ANY TIME.

I agree and understand that I will be held to assume the risk of all terrain, trail and course conditions, including but not limited to weather conditions, trail and course layout and construction, hidden or concealed obstacles, and potential collisions with other riders and wildlife and other vehicles for myself and/or my child(ren) in order to utilize Mt Tam Bikes Camp’s services.

WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Mt Tam Bikes Camp and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Mt Tam Bikes Camp’s services. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

I hereby agree to indemnify and hold Ryan Loften and Mt Tam Bikes Camp and all its officers, directors, employees, representatives and volunteers harmless from and against any and all liabilities for any injury which may be suffered by me or by my child(ren) arising out of or in any way connected with participation in Mt Tam Bikes Camp program. In the case of a medical or surgical emergency, I hereby give permission to any medical personnel selected by the camp staff to secure proper treatment. I give my full permission for my child(ren) to participate in excursions, including but not limited to, frequent walking, bike, car or other trips to local locations. Use of any pictures or videos of my child(ren) that may be used for camp advertising, promotion and are the sole property of Mt Tam Bikes Camp and Ryan Loften. I acknowledge that camp activities may contain an inherent risk of injury.

I Waive My Right To Sue Mt Tam Bikes Camp: In consideration for Mt Tam Bikes Camp agreeing to provide me with cycling on and off road and mountain biking instructions and/or allowing me to participate in this class or lesson, I agree that I shall not make a claim or bring any action against, sue, or hold responsible, Marin County, Mt Tam Bikes Camp, its owners (including Ryan Loften), officers, agents, employees, associates, representatives, (referred to collectively in this agreement as “Mt Tam Bikes Camp") or expect, require, or pursue them, to be held accountable for any damages. I voluntarily agree to release, discharge, and hold harmless Mt Tam Bikes Camp from and against any and all claims of liability, even those arising out of their negligence, fault, recklessness, or any other act or omission which causes me damages, illness, injury, disease, or death, of any nature in any way connected with my participation in this activity. I also expressly agree to release and discharge Mt Tam Bikes Camp from any act or omission, excluding acts of wanton or gross negligence, in rendering or failing to render any type of rescue, emergency or medical services.
Indemnity: I further agree, to hold harmless, defend, and indemnify Mt Tam Bikes Camp and Marin County from all defense costs, including attorney's fees incurred in connection with any claims arising from the activities anticipated herein, including but not limited to those for bodily injury, wrongful death, or property damage, whether caused by or sustained by any minor under 18 years of age on whose behalf I am signing, or which I may have caused to spectators or other third parties, whether negligent or not, in the course of my participation in this activity. In the event of any actions, regardless of where the venue lies, any such actions shall be filed in the State Court of Marin County, California. In the event that any action is filed other than in the State Court of Marin County, California, it shall be moved to State Court of Marin County, California on motion and at the option of Mt Tam Bikes Camp. 3. Transportation Release: I hereby give permission to authorized representatives of Mt Tam Bikes Camp and contracted drivers to provide transportation in an authorized vehicle for my child to be transported to and from camp, and to participate in camp activities. I do hereby indemnify and agree to hold harmless Mt Tam Bikes Camp, and its administrators, employees, and persons transporting my child for any claim arising out of any injury or incident in the course of providing transportation for my child.
Permission to Obtain Medical Assistance: In the event of any injury, illness, emergency, accident or other harm sustained by me (or by the minor on whose behalf I am signing this document), I hereby give Mt Tam Bikes Camp permission to obtain Medical Assistance, in which event I hereby make the same releases and waivers in Mt Tam Bikes Camp's favor as I have otherwise made in this agreement in connection with any such medical assistance sought or not sought. In addition, the expenses for any such medical emergency shall be my sole responsibility and not that of Mt Tam Bikes Camp.

"THE CONDITIONS OF ENROLLMENT"

By signing the camp registration form you are indicating to us that you have read, understood and agreed to the following "Conditions" of enrollment. Please contact us with any questions or concerns you may have before registering for camp. Our intention is to have all of our policies clearly listed, most of which are common sense. The policies and procedures have been adapted from other similar programs.

IMPORTANT INFORMATION FOR PARENTS:

Please read carefully through the Conditions of Enrollment and all other information available to you. It will help you to be fully informed on matters concerning Mt Tam Bikes Camp, your child(ren), and you. We want to serve you and yours well. If you are ever in doubt, please feel free to contact us.

SAFETY FIRST

At Mt Tam Bikes Camp, we practice safety first, always and everywhere. However, Mt Tam Bikes Camp does not assume responsibility for accidents and illnesses. Each family is required to possess Health and Medical insurance for their child(ren).

TUITION AND REFUND POLICY

Formal enrollment for summer 2024 begins as soon as the Registration Form is submitted, signed as indicated, and paid in full (unless previously arranged). It is understood that Mt Tam Bikes Camp has a limited enrollment and reserves the right to refuse entry and acceptance into the camp program or remove a child for any reason. Please refer to our FAQ page for our cancellation/refund policy at www.mttambikescamp.com or contact us with any questions.

RETURNED CHECKS

In the event the bank returns a check with "insufficient funds", we require a replacement check in the original amount plus coverage of any fees charged to our account by our bank due to this matter.

HEALTH

If Mt Tam Bikes Camp staff, in its judgment, believes my child(ren) requires medical attention and/or in the event of a medical or surgical emergency, we hereby give permission, to any EMT, paramedic, nurse, physician, first responder and/or first-aid trained personnel selected by the camp staff to secure, at the parents' expense, proper treatment, including hospitalization, if necessary, for my child(ren). I understand that it is my responsibility to provide my child(ren) with the necessary precautions and clothing against the natural elements (the sun, etc.). While Mt Tam Bikes Camp does carry limited medical insurance coverage, I agree that my and/or my child(ren)’s medical insurance will be primary.

WAIVERS OF LIABILITY

We agree that Mt Tam Bikes Camp is not responsible for the loss or damage to the camper’s personal belongings by fire, water damage, theft, etc. We understand that Mt Tam Bikes Camp forbids campers bringing along mp3 players, game boys, toys or anything of emotional or financial value besides bikes. I give consent for my child(ren) to travel in an authorized vehicle on Mt Tam Bikes Camp to ride locations in and around Marin County and Sonoma County.

Summer camp activities take place mainly in the out-of-doors, in natural and man-made environments, and contain inherent risks of serious injury, including partial or full paralysis, death. This disclosure is not meant to alarm you or to suggest that camp activities are unsafe. By enrolling your child(ren) in Mt Tam Bikes Camp, you agree to accept and assume any and all risk of such injury, death, and damages or property damage to or by your child(ren), which may arise out of or in connection with your child(ren)’s participation at camp.

We hereby release and agree to indemnify and hold harmless, Mt Tam Bikes Camp, and all of its officers, directors, employees, agents and representatives what so ever from any and all loss, claims, damages, and liabilities, costs and expenses (including attorney fees) which they or any of them, or camper may sustain or incur in any way arising out of or in connection with the camper’s participation in any and all camp activities.

We understand and acknowledge Mt Tam Bikes Camp and all its officers, directors, employees, agents, and representatives are relying upon this representation in enrolling the campers for summer camp and without this waiver, the camper will not be enrolled.

GENERAL MATTERS

* We agree that the camper and his/her parents, guardians and or relatives will abide by the rules and regulations set by the camp for health, safety, and welfare of the camper.

* We understand that the camp reserves the right to dismiss a camper whose conduct is dangerous, illegal, or, in the discretion of the Camp Director, detrimental to the camp and/or to other campers or otherwise unsatisfactory.

* We agree that there will be no refund in the event of a dismissal.

* We agree that the camp reserves the right to cancel, change or substitute sessions when necessary.

* We understand that some activities require more stamina than our camper is exposed to for much of his daily routine and lifestyle. We certify to you that the camper suffers from no physical or medical condition that could make his/her participation unsafe or unusually dangerous to the camper or others.

* Possession or use of any drugs, alcohol, and weapons is strictly prohibited at Mt Tam Bikes Camp.

Mt Tam Bikes Camp has a ZERO TOLERANCE for violence. Any violence. (Pushing, hitting, kicking, etc.), inappropriate touching or language may result in an immediate dismissal from camp.

I understand and certify that my child(ren)’s participation in Mt Tam Bikes Camp and its activities are completely voluntary and I have familiarized myself with the camp’s programs, policies, and activities.

THIS IS A LEGAL DOCUMENT. MY SIGNATURE IS MY ACKNOWLEDGMENT OF THE CONTENTS OF THIS CONTRACT. I WILL NOT SIGN THIS DOCUMENT UNLESS I FULLY UNDERSTAND AND AGREE TO BE BOUND BY ITS CONTENTS. I HAVE READ THIS DOCUMENT IN ITS ENTIRETY AND IT IS MY INTENTION THAT IT BE BROADLY CONSTRUED IN FAVOR OF MT TAM BIKES CAMP IN THE EVENT OF ANY AMBIGUITIES, WHICH SHALL BE RESOLVED IN MT TAM BIKES CAMP'S FAVOR. I UNDERSTAND THAT I OR ON BEHALF OF MY MINOR CHILD, AM ASSUMING ALL THE RISKS INHERENT IN THIS CYCLING ON AND OFF-ROAD AND MOUNTAIN BIKING ACTIVITY, AND THAT I OR MY MINOR CHILD MAY BE INJURED, BECOME ILL, OR EVEN DIE AS A RESULT OF CYCLING ON AND OFF-ROAD AND MOUNTAIN BIKING. I UNDERSTAND THAT THIS IS A RELEASE OF ANY AND ALL CLAIMS. I UNDERSTAND THAT THIS IS THE ENTIRE AGREEMENT BETWEEN ME AND MT TAM BIKES CAMP, AND THAT NO REPRESENTATIONS HAVE BEEN MADE TO ME BY MT TAM BIKES CAMP OUTSIDE OF THIS AGREEMENT. I VOLUNTARILY SIGN MY NAME AS EVIDENCE OF MY ACCEPTANCE OF ALL THE PROVISIONS IN THIS RELEASE AND MY AGREEMENT TO BE BOUND BY THEM.

I have read, understand and agree to the terms and conditions set forth above. *

I agree

Parent/Legal Guardian Signature
Please sign below using your mouse. *

clear

Current Total:

$0.00