Summer Camp - Rocky Mountain Farmers Union

2022 Camp Updates

Our 2022 Cooperative Leadership Camp has been scheduled for July 8th-11th at YMCA of the Rockies in Estes Park Colorado. Registration deadline is June 27th. Spots are limited, so don't delay!

Camper Registration: Required Documentation

To complete the registration parents must upload the child's 1. Official Colorado Department of Public Health and Environment (CDPHE) Certification of Immunization, 2. a SIGNED copy of a physical examination performed within the preceding 24 months of the camp dates, and 3. a copy of child's health insurance card front and back. For questions about this application, or the 2022 Camp, please contact Jennifer Luitjens Bahr at 303-283-3550 or via email at jennifer.bahr@rmfu.org

2022 Camps

RMFU Member ID

If you are a current member or associate member please add your seven-digit member ID here.

Payment Method(Required)

Pay with Credit Card (Please Call Michele Parker at 303-283-3538 to pay with credit card)

Mail in Payment: 7900 E. Union Ave., Suite 200, Denver, CO 80237

Which camp will your child attend?(Required)

July 8-11 at YMCA of the Rockies, Grades 2-12

Cost

Camp Registration Options

RMFU Membership - $200

Nonmember Includes a $45 Associate Membership - $245

Nonmember who does not wish to purchase the Associate Membership - $320

Campership - $0

Total

About the Camper

One form must be completed for each camper.

Camper Name(Required)

First Last

Camper Gender(Required)

Male

Female

Camper Birthdate(Required)

Last Grade Camper Completed(Required)

Camper Home Address(Required)

Street Address City State ZIP Code

County(Required)

Please include the County where the camper lives.

Camper Cell Phone

Camper Email

Enter Email Confirm Email

What is the Camper's T-Shirt Size?(Required)

Parent/Guardian 1: Information

Parent 1: Name(Required)

First Last

Parent 1: Cell Phone(Required)

Parent 1: Email(Required)

Enter Email Confirm Email

Parent 1: Address(Required)

Street Address City State ZIP Code

Parent 1: Employer Information(Required)

Employer's Name Address City State ZIP Code

Parent 1: Employer Phone(Required)

This number will only be used if we cannot get a hold of either parent or emergency contact.

Parent/Guardian 2: Information

If there is not a second parent to be listed, please mark fields with N/A.

Parent 2: Name(Required)

First Last

Parent 2: Cell Phone

Parent 2: Email

Enter Email Confirm Email

Parent 2: Address

Street Address City State ZIP Code

Parent 2: Employer Information

Employer Name Street Address City State ZIP Code

Parent 2: Employer Phone

This number will only be used if we cannot get in contact with either parent or listed emergency contact.

Emergency Contact: Information

Emergency contact, if not available in an emergency, notify:

Emergency Contact: Name(Required)

First Last

Emergency Contact: Phone(Required)

Emergency Contact: Email(Required)

Enter Email Confirm Email

Emergency Contact: Address(Required)

Street Address City State ZIP Code

Transportation

Parents are responsible for transportation to and from camp. Please list a secondary pick-up/drop-off person that is someone other than a parent.

Secondary pick up/drop off person(Required)

This camper will NOT be allowed to leave with anyone not listed. A camp staff member may request identification.

First Last

Relationship(Required)

Cell Phone(Required)

Address(Required)

Street Address City State ZIP Code

Is there a person the camper is NOT allowed to leave with?(Required)

Name(Required)

Consent(Required)

Acknowledgement of Responsibility and Release of Liability

Our child will attend the Rocky Mountain Farmers Union Cooperative Leadership Camp in June 2022. In consideration of his or her attendance at the Camp, we agree that Rocky Mountain Farmers Union and YMCA of the Rockies are not responsible for any accident or injury affecting my child or children during the time spent at camp or while being transported to or from the camp or camp activities. We agree to hold harmless and indemnify Rocky Mountain Farmers Union, YMCA of the Rockies, and their staffs, representatives, and employees from all liability in relation to our use of the premises, travel to and from the camp, engagement in Camp activities, use of materials or equipment, buildings and/or operations of the Rocky Mountain Farmers Union Cooperative Leadership Camp. We hereby agree to release the above entities from all liability for any economic and non-economic losses due to bodily injury, death, and/or property damage sustained by me and/or my minor child or legal ward. We understand that Rocky Mountain Farmers Union and YMCA of the Rockies will take all reasonable precautions to ensure the safety, health and well-being of my child by the exercise of due care and by following all regulations and guidelines.

Parent Signature(Required)

First Last

By typing your name above, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form.

Date(Required)

Is the child covered by family health insurance?

Yes

No

Upload a copy of your camper's medical/physical form signed by a doctor

Max. file size: 50 MB.

A link to a blank copy of this form can be found at the top of this webpage.

Upload a copy of the FRONT of camper's health insurance card

Max. file size: 50 MB.

Health Insurance: please upload a copy of the FRONT of the camper's health insurance card.

Upload a copy of the BACK of camper's health insurance card

Max. file size: 50 MB.

Health Insurance: please upload a copy of the BACK of the camper's health insurance card.

Upload official Colorado Department of Health & Environment Certificate of Immunization

Max. file size: 50 MB.

Immunization: Please upload a copy of the child’s official Certification of Immunizations issued by the Colorado Department of Public Health and Environment (CDPHE) record including the date of the last tetanus shot.

What was the date of your last physical examination?

Upload physical examination form

Max. file size: 50 MB.

Physical Examination: must be signed by your doctor and performed within the preceding 24 months of the camp dates.

Parent Signature

I hereby give permission to the medical personnel selected by the camp director to order x-rays, routine tests, treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation for my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director to secure and administer treatment, including hospitalization, for the person named above. If for a religious, medical, or personal reason you do not desire to sign this, contact the camp for a legal waiver which must be signed for attendance.

Signature

First Last

By typing your name above, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form.

Payment

Please either mail a check to Rocky Mountain Farmers Union Foundation, 7900 E. Union Ave., Suite 200, Denver, CO 80237 OR Call Michele Parker at 303-283-3538 during regular business hours to pay by check.

Total

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Phone

This field is for validation purposes and should be left unchanged.

RMFU Summer Camp

July 8-11, at YMCA of the Rockies, Estes Park, Colorado

2022 Camp Updates

Camper Registration: Required Documentation

2022 Camps

Cost

About the Camper

Parent/Guardian 1: Information

Parent/Guardian 2: Information

Emergency Contact: Information

Transportation

Parental/Guardian Permission

Application of Sunscreen

General Health History

Payment

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