Elite Resident Camp Application

Medical Information

Select Camper Registration Option

Digital Signature
I have read the above and agree to my child's participation. (signature required)

Insurance Provider

Policy Number

I give my written permission for my child to be treated by a doctor if necessary. They are physically fit according to our family doctor.
(signature required)

Total Price: $0

Waiver Statement

All Campers have their own medical coverage. The camp provides only excess coverage (does not cover deductibles or co pays) after your insurance policy has been utilized. Campers will not be allowed to participate unless the following information is submitted and the form signed by the parent or guardian of the camper. I agree to hold harmless Gardner-Webb University for my voluntary participation.

Questions about this event? Please contact Tony Setzer tsetzer@gardner-webb.edu or 704.406.3856

Auxiliary aids will be made available to persons with disabilities upon request 48 hours prior to the event. Please call 704.406.4253 or email servicerequests@gardner-webb.edu with your request.