2025 Widener Health Career Explorers Summer Camp

HIDDEN: Form Date

First Name*

Last Name*

Pronouns

Student Email Address*

Birthdate*

Mailing Address*

Country

Street

City

Region

Postal Code

Mobile Phone Number

May we text you?

Yes

No

Parent/Guardian Name*

Parent/Guardian Email Address*

Parent/Guardian Phone Number*

Parent/Guardian 2 Name

Parent/Guardian 2 Email Address

Parent/Guardian 2 Phone Number

Current/Most Recent School*

High School Graduation Year:*

Academic Interest*

Food or other allergies

T-shirt size

CONDITIONS OF ENROLLMENT

1. I understand that part of the camping experience involves activities and interactions that may be new to my child. These things come with certain risks and uncertainties beyond what my child may be used to dealing with at home. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free, and so I have instructed my child on the importance of abiding by the camp’s rules. My child and I both agree that my child will obey these rules.

2. I agree that any dispute concerning, relating, arising out of or referring to the subject matter of this contract shall be resolved exclusively by binding arbitration in Delaware County, Pennsylvania, according to the then existing commercial rules of the American Arbitration Association and the substantive laws of Pennsylvania. Any claim brought for breach of the agreement, the non-prevailing party shall, in addition to any other remedies, be required to pay prevailing party’s attorney fees and other costs of defense.

3. Students and parents/guardians agree to abide by Widener rules and regulations.

CONDITIONS OF ENROLLMENT

1. I understand that part of the camping experience involves activities and interactions that may be new to my child. These things come with certain risks and uncertainties beyond what my child may be used to dealing with at home. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free, and so I have instructed my child on the importance of abiding by the camp’s rules. My child and I both agree that my child will obey these rules.

2. I agree that any dispute concerning, relating, arising out of or referring to the subject matter of this contract shall be resolved exclusively by binding arbitration in Delaware County, Pennsylvania, according to the then existing commercial rules of the American Arbitration Association and the substantive laws of Pennsylvania. Any claim brought for breach of the agreement, the non-prevailing party shall, in addition to any other remedies, be required to pay prevailing party’s attorney fees and other costs of defense.

3. Students and parents/guardians agree to abide by Widener rules and regulations.

I, as parent/guardian of registering student, understand and consent.

Photo/Video Consent

I consent to have my child participate in photographs and videos of Widener’s Health Career Explorers Summer Program and to have those photos and/or videos used for promotional use.

Photo/Video Consent

I consent to have my child participate in photographs and videos of Widener’s Health Career Explorers Summer Program and to have those photos and/or videos used for promotional use.

I, as parent/guardian of registering student, understand and consent.