Camper Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone *

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Would your child be able to access Camp Valor through Zoom? *

My child has access to the internet and a device they could use to join virtual camp.

My child does NOT have access to the internet and a device they could use to join virtual camp.

My child has a device they could use to join virtual camp but not access to the internet.

If registering multiple children, would each child have access to their own device to join Camp Valor through Zoom? *

Yes, my children would each have their own device to join Camp Valor through Zoom.

No, my children would need to share a device to join Camp Valor through Zoom.

I am only registering one child.

I hereby give permission for my child to participate in Camp Valor through Zoom. I freely waive all rights to any future claims against the Utah Hemophilia Foundation, Camp Valor, camp volunteers, or representatives due to any unforseen circumstance that may occur during the camp period. I also give my child permission to participate in educational programs at camp, including general health education and home infusion therapy training, if appropriate. *

I agree.