Student's Name *

First Name

Last Name

Name *

First Name

Last Name

Mode of transportation. Please select one. *

Driving into and out of Woodshed and shuttle service is not needed.

Driving Into Woodshed and Flying Out of Woodshed through Denver International Airport (DEN)

Flying Into Woodshed and Flying Out of Woodshed through Denver International Airport (DEN)

Flying Into Woodshed through Denver International Airport (DEN) and Driving Out of Woodshed

Incoming Flight Info on July 22

Please check the box below to let us know if a parent/guardian will be flying with the student.

Yes, a parent/guardian will fly with the student

No, a parent/guardian will not fly with the student

We will be traveling by car

Outgoing Flight Info July 27 *

Please check the box below to let us know if a parent/guardian will be flying with the student.

Yes, a parent/guardian will be flying with the student

No, a parent/guardian will not be flying with the student

We will be traveling by car

By checking this box, I acknowledge the following: *

If my dancer is under 16, airline carriers have different guidelines for travel. I acknowledge that I have researched my dancer's specific age needs and have made the proper arrangements with the airline.

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please select one

This information is for medical purposes only in case of emergency.

Female

Male

Other

Parent/Guardian Name *

First Name

Last Name

Parent/Guardin Phone *

(###)

###

####

Name of additional emergency contact

First Name

Last Name

Phone of additional emergency contact

(###)

###

####

Physician's Name *

First Name

Last Name

Physician's Phone

(###)

###

####

Policy holder's Name

First Name

Last Name

Policy holder's date of birth

MM

DD

YYYY

Prescribing Physician's Name

First Name

Last Name

Prescribing Physician's Name

First Name

Last Name

Prescribing Physician's Name

First Name

Last Name

Allergies

Select all that apply

Hayfever

Poison Ivy/Poison Oak

Insect stings

Food

Penicillin

Other

None

To the best of my knowledge, attendee is up to date with all immunizations.

Yes

No

Health History

Please check all that apply

Recent injury, illness, or infectious disease

Chronic or recurring illness

Asthma

Seizure Disorder

Dizziness during or after exercise

Chest pain during or after exercise

Heart Defect/Disease

Hypertension

Bleeding/Clotting Disorders

Diabetes

Mononucleosis (in last 12 months)

Chicken Pox

Measles

Mumps

Tuberculosis

Hepatitis

Joint problems

Fractures

Frequent headaches

Head injury

Eating Disorder

Diarrhea or constipation

Frequent Stomach Aches

Wears glasses or contacts

Been hospitalized (within last 12 months)

Wears a Medic Alert ID

Checkbox *

My attendee has permission to engage in all prescribed MiNI Shed Tap Camp activities except as noted. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury. I hold harmless any and all MiNi Shed Tap Camp staff. By checking the box below, I consent to the above statements.

I consent

Name *

First Name

Last Name

Name of Parent/Guardian *

First Name

Last Name

By checking the box below, I agree to the following statements. *

I as the ATTENDEE or PARENT/GUARDIAN of ATTENDEE hereby acknowledge that I freely and voluntarily permit listed attendee to participate in The MiNi Shed Tap Camp to be held on the campus of the YMCA of the Rockies, during the time period JULY 22 THROUGH JULY 27, 2025 (the “Camp”). I understand that participation in the Camp is completely voluntary; that ATTENDEE is under no obligation to take part in the Camp; that the Camp is provided through The MiNi Shed Tap Camp to enhance ATTENDEE's educational experience; and that NO INSURANCE COVERAGE MAY EXIST THROUGH The MiNi Shed Tap Camp TO COVER ANY CLAIMS THAT MAY ARISE OUT OF ATTENDEE's PARTICIPATION IN THE CAMP. In consideration for The MiNi Shed Tap Camp arranging this opportunity for ATTENDEE to participate in the Camp and enhancing ATTENDEE's educational experience, ATTENDEE or PARENT/GUARDIAN of ATTENDEE have fully read this Release of Liability and hereby execute this Release with the intent to bind ATTENDEE or PARENT/GUARDIAN of ATTENDEE, spouse (if applicable), ATTENDEE's heirs, assigns, and legal representatives. I further represent that ATTENDEE or PARENT/GUARDIAN of ATTENDEE is at least eighteen (18) years of age and competent to sign this affirmation and release. I understand that on some occasions, ATTENDEE must arrange THEIR own transportation related to the Camp and/or on some occasions, The MiNi Shed Tap Camp may arrange transportation. I further understand and agree that ATTENDEE's decision to accept transportation from The MiNi Shed Tap Camp is completely voluntary and accepted at THEIR own risk, that THEY are not required to accept such transportation, and that such transportation will not be covered by any The MiNi Shed Tap Camp insurance. ATTENDEE or PARENT/GUARDIAN of ATTENDEE understand that if ATTENDEE chooses to take THEIR own automobile, THEY must provide THEIR own automobile collision and liability insurance. ATTENDEE or PARENT/GUARDIAN of ATTENDEE also understands that if ATTENDEE accepts transportation offered to THEM by another Camp participant and/or The MiNi Shed Tap Camp student, staff, or faculty member driving their own automobile, that ATTENDEE accepts such transportation at THEIR own risk. ATTENDEE or PARENT/GUARDIAN of ATTENDEE understand and agree that whatever alternate mode of transportation THEY may choose will not be covered by any self-insurance, or insurance policy owned by The MiNi Shed Tap Camp . ATTENDEE or PARENT/GUARDIAN of ATTENDEE fully understand and acknowledge that certain elements of the Camp may be physically and emotionally demanding and that by ATTENDEE'S participation in the Camp, THEY face risks of accidental and/or other physical and/or emotional injuries. These risks may include, but are not limited to, (1) loss or damage to personal property; (2) physical or emotional injury or fatality due to, and/or related to, (a) all modes of travel while participating in the Camp, whether by airline, automobile, train, boat, trolley, taxi, bus, public transportation or walking, (b) the condition of facilities away from the YMCA campus, which are not under the control and maintenance of The MiNi Shed Tap Camp , (c) exposure to inclement weather, outdoor terrain, and all the risks inherent therein, including but not limited to: sunburn, heat exhaustion, insect bites/allergies, dust, dirt, etc., as well as any and all injuries, whatsoever, which may be sustained from activities of the camp, including, but not limited to, any and all injuries related to physical activity, such as walking, running, jumping, swimming, handling athletic equipment, being exposed to others handling athletic equipment, colliding with other participants, and slips and falls, (d) any and all other aspects and stress related to the Camp, including interaction with personnel who are not employees of The MiNi Shed Tap Camp , risks inherent to staying overnight in a campus residential facility, and risks inherent to travel to a rural or metropolitan area, and (e) suffering any type of injury, illness, or infectious disease without immediate access to medical facilities. ATTENDEE or PARENT/GUARDIAN of ATTENDEE understand and voluntarily choose to allow ATTENDEE to assume the risks of ATTENDEE'S participation in the Camp and hereby represent that THEY are able to participate in this Camp, with or without reasonable accommodations. ATTENDEE or PARENT/GUARDIAN of ATTENDEE further acknowledge that ATTENDEE has asked for and has received reasonable accommodations for any disability ATTENDEE may have brought to the attention of the STAFF, having first presented valid certification of THEIR disability. ATTENDEE or PARENT/GUARDIAN of ATTENDEE agree to advise the STAFF at any point when ATTENDEE questions THEIR ability to participate in any activity of the Camp. I EXPRESSLY AGREE AND INTEND THAT ATTENDEE'S PARTICIPATION IN THE CAMP SHALL BE UNDERTAKEN BY ATTENDEE AT THEIR OWN RISK AND THAT NEITHER The MiNi Shed Tap Camp , ITS TRUSTEES, OFFICERS, EMPLOYEES, STUDENTS, AGENTS, VOLUNTEERS, NOR ASSIGNS SHALL BE LIABLE FOR ANY INJURIES, DAMAGES, CLAIMS, DEMANDS, ACTIONS OR CAUSES OF ACTION WHATSOEVER WHICH MAY ARISE OUT OF OR IN CONNECTION WITH ATTENDEE’S PARTICIPATION IN THE CAMP, WHETHER FROM ACTS OF ACTIVE OR PASSIVE NEGLIGENCE ON THE PART OF ATTENDEE AND/OR ON THE PART OF WOODSHED EXPERIENCE, ITS TRUSTEES, OFFICERS, EMPLOYEES, STUDENTS, AGENTS, VOLUNTEERS, OR ASSIGNS, AND ATTENDEE or PARENT/GUARDIAN of ATTENDEE DO HEREBY FOREVER RELEASE, DISCHARGE, INDEMNIFY, HOLD HARMLESS AND WILL DEFEND WOODSHED EXPERIENCE, ITS TRUSTEES, OFFICERS, EMPLOYEES, STUDENTS, AGENTS, VOLUNTEERS, AND/OR ASSIGNS FOR ANY SUCH INJURIES, DAMAGES, CLAIMS, DEMANDS, ACTIONS, OR CAUSES OF ACTION. The terms of this Release of Liability are to be governed by and construed under the laws of the State of Texas. In the event any term or provision of this Release of Liability is found to be unenforceable or void, in whole or in part, the term or provision concerned shall be construed as valid and enforceable to the maximum extent permitted by law, and the balance of this Release of Liability shall remain in full force and effect. ATTENDEE or PARENT/GUARDIAN of ATTENDEE agree that exclusive venue for any dispute arising between The MiNi Shed Tap Camp and attendee involving this Release of Liability in any way shall be in the state of Texas.

I agree

Name *

First Name

Last Name

Select from the list below all that applies to your situation. *

No restrictions

Gluten Free

Vegetarian

Vegan

Dairy Free

Pescatarian

No pork

Other

Please select one of the following *

I do not have food allergies

I do have food allergies

Name *

First Name

Last Name

Please select your T-Shirt size. *

When in doubt, size up. Please only check one box. Exchanging of sizes will not be possible at the event.

Large Child

Small Adult

Medium Adult

Large Adult