Mt Tam Bikes Camp Registration 2019

(This form is private and secure. We do not share any information.)

Camper/Child Information

Gender *
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Camper/Child Home Information

Camper/Child Riding Experience

Campers do not need prior mountain biking experience but they must already be comfortable riding a bike. Participants must have the ability to start, stop, turn and ride in a controlled manner for 1-3 miles. If your child has recently learned to ride and/or is struggling with the basics, they are not yet ready for camp this year. Please contact us with any questions/concerns as we are available for private assesments and instruction.
Please select one: *

2019 Summer Sessions

All Sessions are $535 each.  You can register to be wait-listed for one or more FULL sessions.  (PLEASE DO NOT SEND PAYMENT FOR WAIT-LISTED SESSIONS) Always feel free to contact us with any questions.
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Parent 1 Information

Parent 2 Information

Emergency Contact

Please DO NOT LIST PARENTS. We will always try and reach parents first in an emergency

Child/Camper Health Information

Please fill out what you have available.
Does the participant have health insurance? (Campers must have Health Insurance to participate) *
Does the participant take any medications? *
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.
Swim Authorization (On occasion we have options for riders to cool off in a local swimming hole with adult supervision) *

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). *
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Misc. Information

Where have you heard about us? *
 

General Release / Waiver "Conditions of Enrollment"

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. Any controversy or claim arising out of or related to my child(ren)’s participation in this camp will be attempted to be settled by a professional mediation service, then by binding arbitration pursuant to the applicable rules of the American Arbitration Association. I understand and agree that my child(ren)’s and/or my own health/medical insurance is primary and agree to be responsible for medical expenses in excess of, or not included in, the camp's policy. I have read, understood and agree to (“The Conditions of Enrollment”). All questions about policies and operations of Mt Tam Bikes Camp have been answered to my satisfaction. I hereby consent to my child(ren) participating in any and all camp activities and I agree to the conditions set forth above.
 

"THE CONDITIONS OF ENROLLMENT"

By signing the camp registration form you are indicating to us that you had read, understood and agree 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. Mt Tam Bikes Camp is insured and provides limited medical insurance coverage for each camper, but each family is expected to possess Health and Medical insurance for their child(ren), which will be used first, with the camp insurance as a backup.  

MEDIATION/ARBITRATION

Any controversy or claim arising out of or related to my child(ren)’s participation in this camp will be attempted to be settled by a professional mediation service, then by binding arbitration pursuant to the applicable rules of the American Arbitration Association.

TUITION AND REFUND POLICY

Formal enrollment for summer 2019 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. Due to the small size and limited enrollment of this course, all sessions are non-refundable. We do our best to be as flexible as possible concerning this policy. Please refer to our FAQ page 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 that 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.

I have read and agree to the terms and conditions set forth above. *
Parent/Legal Guardian Signature
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