We recommend that you use a desktop to fill out this application. 2021 Application Form Step 1 of 5 20% This Application Form take about 15 minutes to complete. Before applying, please read the following: 1. Response Time: We will confirm your spot(s) or place you on a wait list within three business days. 2. Payments & Discounts: Paying by check: Please wait for us to confirm that there is space before sending your check. Paying by credit card: if there is space, we will charge your card $900/camper. View our Rates, Dates Discounts and Evolving Cancellation Policies. 3. Flexibility, Please: As with everything COVID, we may need to alter our current plans before summer. As always, we will keep you informed and work with you.This Application Form take about 15 minutes to complete. Before applying, please read the following: 1. Response Time: We will confirm your spot(s) or place you on a wait list within three business days. 2. Payments & Discounts: Paying by check: Please wait for us to confirm that there is space before sending your check. Paying by credit card: if there is space, we will charge your card $900/camper. View our Rates, Dates Discounts and Evolving Cancellation Policies. 3. Flexibility, Please: As with everything COVID, we may need to alter our current plans before summer. As always, we will keep you informed and work with you.2021 Quarantine Policy*We really, really want to run camp for your child this summer! All of our kids need to be outside, off screens and together! For us to do that in the time of COVID, we are asking you – and everybody in our small community – to make some commitments that will assist in our efforts to keep camp healthy and safe. As we plan for a summer that will not be back to normal, we continue to consult with the health department, doctors, and policy makers at the State and Federal levels. And, even as vaccines are starting to be delivered, we are not betting on the availability of vaccines for staff and campers prior to the summer. We are confident that this policy, which may still be in place in June & July, will be the most conservative policy we implement: Campers will be required to quarantine for at least seven days prior to their session, and receive a negative COVID test within 72 hours of their arrival. For the quarantine time period this means: - Campers will interact only with their immediate family, and will wear masks when that includes in-home childcare and grandparents. - If there are necessary interactions in public (Drs. Appts, dentist, co-workers, etc.) campers, and their families, will wear masks. And: - No travel by plane or public transportation - No restaurants, bars, sporting events, concerts, etc. - No attending other camps (We are considering allowing siblings to attend childcare and day camps where masks are worn all times.) - No playdates, parties, or gatherings outside the immediate family (including outdoor events, like 4th of July) Attending or working at CGL this summer will be a shared commitment. Our counseling staff, summer leadership team, and the Year-Round Directors are agreeing to live with strict precautions throughout the summer. For example, staff are being hired with the expectation that they arrive more than two-weeks early, stay in small pods for 10 days, test negative, and cannot leave camp the entire summer, other than on accompanied trips to parks or trails. I understand that these quarantine policies are in place, and agree to plan for this to keep the entire camp community healthy this summer.Immunization Policy*We require campers and staff to be FULLY immunized (per state guidelines) before camp begins. Campers and staff with medical exceptions will be allowed at camp with documentation from their physician. We are sorry, but personal exemptions will not be accepted. COVID Note: Right now, and until a COVID vaccine is available and proved effective, this will not be a required vaccine. This may change, of course, and we will notify you of that change if it happens. I agree to the Immunization Policy. Parent / Guardian Name* First Last Parent / Guardian Email*This is the email address we will use to communicate with you about camp, and ask that you use it to communicate with us, too! Thanks. Parent / Guardian Mobile Phone*Would You Like to Add a Second Parent / Guardian to Your Account?*You can always contact us to add them later, too.YesNoRelationship To You* Second Parent / Guardian* First Last Second Parent / Guardian Email* Second Parent / Guardian Mobile Phone*Would you like us to include this person on emails about camp, too?*YesNo Camper InformationHow many campers would you like to apply for today?*123Camper #1: Name* First Last Which Session Would you Like to Apply for Camper #1?*View our Rates, Dates Discounts and Evolving Cancellation Policies. Age groups designated as "limited availability" may be on WAIT LIST, we just haven't updated it yet. Session 1, June 21 - July 10 2021 Session 2, July 12 - July 31 2021 Camper #1: Current Grade*2nd3rd4th5th6th7th8th9th10thCamper #1: Date of Birth*Please make sure you get the right year (sometimes people just put the current year!)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper #1: Gender* Camper #2: Name* First Last Which Session Would you Like to Apply for Camper #2?*View our Rates, Dates Discounts and Evolving Cancellation Policies. Age groups designated as "limited availability" may be on WAIT LIST, we just haven't updated it yet. Session 1, June 21 - July 10 2021 Session 2, July 12 - July 31 2021 Camper #2: Current Grade*2nd3rd4th5th6th7th8th9th10thCamper #2: Date of Birth*Please make sure you get the right year (sometimes people just put the current year!)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper #2: Gender* Camper #3: Name* First Last Which Session Would you Like to Apply for Camper #3?*View our Rates, Dates Discounts and Evolving Cancellation Policies. Age groups designated as "limited availability" may be on WAIT LIST, we just haven't updated it yet. Session 1, June 21 - July 10 2021 Session 2, July 12 - July 31 2021 Camper #3: Current Grade*2nd3rd4th5th6th7th8th9th10thCamper #3: Date of Birth*Please make sure you get the right year (sometimes people just put the current year!)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper #3: Gender* Payment Details-Method of Payment: At this time, you can choose to pay by Mastercard, VISA, or check. -Confirmation of Space: No charges will be made to credit cards until we confirm that we have space. We will reach out if we need to place your camper on a wait list. - Payment Schedule: • Deposit with Registration: $900/camper, Refundable for 14 days • Second Installment: March 15th. $900, Refundable until March 31st, 2021 • Final Installment: May 1st. Remaining Balance, Refundable until May 31st, 2021 - We can work with you! Need a an alternative payment schedule, scholarship, or other method of payment, please complete this application by choosing "Please call me to discuss." Discounts: We will apply all discounts (early bird, referral, sibling, returning,) to your account "by hand" after you submit this form. We will send you a statement within a week. Please select your payment schedule:*$900/ camper deposit today (once space is confirmed); $900/camper installment on 2/15; Final Balance on 4/1Please Call Me to DiscussHow Would You Like to Pay For Camp?*Credit CardCheckPay By Check: Once We Confirm Your SpotPlease send acheck ($900 / camper) made out to "Camp Granite Lake" to: Camp Granite Lake 11902 Camp Eden Road Golden, CO 80403 HiddenCredit Card PaymentDeposit (Hidden)Total Deposit Due:(# of campers applied for x $900) Bill To Email*(Even if it's the same as an adult you've already entered.) Credit Card* MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name Credit Card Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands * I authorize you to charge this card for deposits and future camp tuition. TERMS OF AGREEMENT It is important that a parent or legal guardian ("parent") and their families understand our policies. Parents: Please read carefully, review with your children, sign below and contact us if you have questions. Non-discrimination Policy CGL does not discriminate in their respective employment or admissions policies on the basis of race, color, gender, sexual orientation, religion, national or ethnic origin, age or disability. Photo Release By signing this form, you authorize CGL to take and use you or your family’s photo, written statement and/or audio or video recording and use it in any manner it desires, for program, promotional or other use. Right to Dismiss a Participant CGL reserves the right to dismiss any participant that staff believes, in their judgment, presents a safety concern or medical risk, is disruptive, or engages in behavior detrimental to the program. If a participant is dismissed or departs for any reason, parent is responsible for all costs of early departure whether for medical reasons, dismissal, personal emergencies or otherwise. COVID-19 Notice COVID-19 is a respiratory illness that appears to spread easily from person to person and may be life threatening to those suffering from it. Your family’s health and safety is important to us. For that reason, we want you to be aware that your child will interact in close proximity to and with other children and adults for periods of time while at camp. Although we will maintain proper (and enhanced) hygiene and infection control practices, it is impossible to guarantee that your child (or anyone else at camp) will not become sick or be exposed to COVID-19. By signing this document, you acknowledge your understanding that COVID-19 is spreading rapidly through the United States, that during camp your child will spend time around many children and adults, and that it is possible that your child and family may become sick with or exposed to COVID-19, whether at camp or elsewhere. Choosing not to agree will disqualify your child from participating in a program at camp. Terms of Agreement*THE MOUNTAIN DAY CAMP, INC., DBA CAMP GRANITE LAKE: TERMS OF AGREEMENT *Please note additions and/or amendments to our Terms of Agreement located https://campgranitelake.com/terms-updates. TERMS OF AGREEMENT -- Signature required It is important that a parent or legal guardian (collectively "parent"; sometimes “you”, “your”, “I” or “my”) and their camper understand our policies, including these standard Terms of Agreement (“Terms”). Parent: Please read carefully, review with your son or daughter, sign below and contact us if you have questions. In consideration of the services of The Mountain Day Camp, Inc., dba Camp Granite Lake (“CGL”) in allowing camper to participate, I agrees as follows: 2020 CAMPER FAMILIES: If you previously registered for summer 2020 CGL program/s, you have likely already signed a version of these Terms and other forms, and provided requested information. However, because of the unforeseen and unprecedented nature of COVID-19 and associated restrictions, CGL was forced to cancel all 2020 scheduled programs and all existing registrants for this previously planned programming. As a result, if you had previously registered, your registration has been cancelled and your previously signed forms rendered null and void. Consequently you are required to re-register for new programming, complete all required information and read and sign new forms. NOTE: These standard Terms apply to all registrations. In addition, our online policies (linked and referenced above), incorporated here, by this reference, supplement and/or amend these Terms. CGL will determine, in its sole discretion, the extent to which the online policies apply. If there is a conflict between the online policies and these Terms, these Terms shall govern. APPLICATION PROCEDURE: When CGL receives your application, deposit and these signed Terms, we will confirm your enrollment. However, final acceptance and participation in the camp session is contingent on our receipt of your application and these signed Terms, your full and timely payment and our receipt and review of all other required (completed and signed) forms, including the CGL: Acknowledgment and Assumption of Risks & Release and Indemnity Agreement, the CGL Health History Form or other form/s. In March of 2021, CGL will provide access to additional forms. These forms must be completed and signed by June 1, 2021. PAYMENT AND REFUND/CREDIT POLICY: As noted above, your deposit is due with registration. Payment of the remaining balance is due based on CGL’s payment policies. Camper family payment, refund and credit policies for all programs are available at www.campgranitelake.com.* *Our graduated refund policies are intended as liquidated damages and not as a penalty. CGL uses camper payments to prepare for programs, pay its staff and handle a myriad of other costs associated with its budget and operations, and it is therefore difficult to ascertain the amount of actual loss or damages that would result if you cancel your registration at a given point in time. As a result, the noted charges reflect a reasonable estimate of the actual costs CGL will incur in the event of camper cancellation before camp start. RIGHT TO DISMISS A CAMPER: CGL reserves the right not to admit or to dismiss any camper that staff believes, in their judgment, presents a safety concern or medical risk, is disruptive, or engages in behavior detrimental to the program. If a camper is dismissed or departs for any reason, camper (and his/her family) are responsible for all costs of early departure whether for medical reasons, dismissal, personal emergencies or otherwise. NON OR LATE ARRIVAL OR EARLY DEPARTURE: · CGL will not refund or reduce tuition if, for any reason (whether voluntary or involuntary), a camper does not attend, arrives late or leaves the program in progress (including but not limited to voluntary withdrawal, dismissal from the program, illness, injury or any other reason). · Further, if a camper departs from the program early, parent/s are responsible for all costs of early departure whether the departure is for medical reasons, dismissal, personal emergencies or otherwise. As an example, if a participant becomes ill during a program as a result of COVID-19 or otherwise, CGL may need to isolate camper/s, and the program could be cut short or cancelled, with participant/s incurring additional travel and medical expenses. CGL ALTERATION OR CANCELLATION; FORCE MAJEURE: · Please understand that the fluid and potentially changing Federal, State or County requirements/guidance or other factors associated with operating programs in the midst or wake of the COVID-19 Pandemic, may require CGL to alter, suspend or cancel its programming at any time. · CGL reserves the right to alter any aspect of a program, before or during a program, including (e.g.) program itinerary or activities for reasons including but not limited to: weather, environment, logistics or health hazards. CGL expects families to be flexible with these changes, as they arise. Except in the event of a force majeure, refunds related to alterations will only be offered consistent with the CGL Refund Policies. · Force Majeure: CGL reserves the right to alter or cancel a program before or after its start date, because of an Act of God or other political, social, environmental or other condition beyond its control (force majeure). Force majeure events include but are not limited to war or terrorism; civil unrest or emergency; economic collapse; governmental or other authorities’ laws, regulations or other actions, including restrictions on travel, CGL programs or otherwise; floods, fire or other natural disasters; industrial or biological disasters; and health threats, including disease outbreaks, epidemics or pandemics, such as but not limited to the current or future, but unknown impact of COVID-19 on CGL operations. Typically, these events are unexpected and may compromise the health or well-being of Program staff, participants or guests or otherwise prevent our performance. Often, these types of events severely impact programs or make them impracticable or impossible to run (impracticability/impossibility of performance or frustration of purpose). If CGL determines, in its sole discretion, it is unable to perform, in whole or in part, because of a force majeure, CGL may alter, suspend or terminate its performance, the CGL refund policies do not apply and no refunds will be granted (unless, as determined, in CGL’s sole discretion). In the event of a force majeure, you agree that CGL will not be found in breach of this Agreement and/or legally liable to parent/camper for any losses, costs or damages. · In any case, if CGL alters or cancels before or during a program - regardless of whether CGL issues any refund – CGL is not responsible for any indirect, incidental, consequential or other costs, damages or fees camper or parent/s may incur, such as but not limited to non-refundable air or other travel tickets or change fees, equipment purchased for the trip, substituted programs, or otherwise. NON-DISCRIMINATION POLICY: CGL does not discriminate in its employment or admissions policies on the basis of race, color, gender, sexual orientation, religion, national or ethnic origin, age or disability. However, CGL reserves the right to refuse admission or ongoing participation on medical or health grounds, in appropriate cases. PHOTO STATEMENT/AUTHORIZATION: While at the camp property or at camp events off-property, I authorize CGL and/or its agent/s, to photograph, film, record and/or otherwise capture the name, image, voice, verbal or written statement, photograph and/or visual likeness of camper or parent/s (collectively “images”), for use in any media throughout the world in perpetuity, including reproduction or display on the internet, in publications and/or for any informational, promotional or other use without compensation to camper or parent/s. CGL owns these images and I/my child waive any inspection or approval rights. INTERNET POSTINGS; CGL PROTECTED MATERIALS: CGL encourages campers and their families to ‘spread the good word’ about their experiences on program. At the same time, we expect campers and their parent/s to respect our organization, and not to disparage CGL in postings on the Internet (websites, Facebook, YouTube, Twitter, Instagram or other sites). Also, please understand that CGL’s website and information contain copyrighted materials, trademarks, protected trade names and logo/marks that are the sole property of CGL, and (other than downloading or printing for personal use), may not be copied, broadcast, disseminated or publicized, without our written permission. CGL RULES include, but are not limited to: • CGL is not responsible for campers' lost, stolen or damaged personal belongings. In addition, campers and their parent/s will be held responsible for damage to, or loss of CGL property or equipment. This may include sharing in the group's collective responsibility for willful equipment/property destruction or loss. • CGL does not allow a camper’s possession, use and/or distribution of alcohol, cigarettes, vaping devices, tobacco or tobacco like products (such as chewing tobacco), marijuana or other illegal drugs, unauthorized prescription drugs or other controlled substances during camp, whether on or off camp property. • Campers and staff cannot bring animals/pets to any camp activity unless the camp director grants permission. If an unauthorized pet is brought to camp, Camp Granite Lake is not responsible for the actions of the animal or for the animal's safety or well-being. • CGL will not tolerate offensive or dangerous behavior or bullying, abuse or harassment in any form – whether physical or emotional, and whether expressed verbally or in writing, images or conduct, including fighting, violence, or threats. • CGL does not allow electronics of any type at camp, including, but not limited to: cell phones, MP3 players, CD players, iPods, Gameboys, etc. • Campers may not carry or use weapons, weapon like objects or firearms of any kind in camp or on camp property. These will be immediately confiscated by the camp director and may not be returned. The camp director may, in their discretion, make an exception for pocket knives. PARENTS ACKNOWLEDGEMENT OF POLICIES: Among other important information, the Policies for Parents contains a list of CGL activities, including anticipated field trips. These are also listed on the camp web site. Parents must notify CGL in writing at any time before the start of the camp session, if they do not want their child to participate in any activity/s. Parent acknowledges they are responsible for reviewing and abiding by the Policies For Parents [link], included in the parent packet and posted online (and for reviewing applicable portions of those policies with their child before arrival at camp). Importantly, parent should regularly access CGL’s COVID Camp policies [link]. We will update these policies periodically, as necessary. PARENTAL AUTHORITY: I (the parent) certify and represent that I have the legal authority to enroll camper in the camp session, complete CGL registration, and execute all required documents. To the extent necessary, I agree that I have obtained any and all other pertinent consents or authorities (including any required by a court decree or order; for example, a divorce decree, custody order or joint parenting plan). I fully understand and agree that if a camper’s other parent (or anyone else) challenges my authority: a) the camper will not be allowed to attend camp, or, if already at camp, the camper may be sent home without a refund if the parent/s or other parties involved cannot reach agreement, and, b) I agree to indemnify, defend and protect CGL from any claims made by the other parent or any person against CGL, to the fullest extent provided for in the CGL: Acknowledgement and Assumption of Risks & Release and Indemnity Agreement or otherwise, including payment of any costs or attorneys’ fees expended by CGL to resolve a dispute. CGL CHANGES TO TERMS OR SERVICES: • Right to Change Terms. CGL reserves the right to change select provisions of these Terms, with changes reflected on its website at [link]. Except for policies that supplement and/or amend these Terms, as identified on our website, these standard Terms (which may be revised from time to time) remain in full force and effect. • CGL staff will notify parent in writing of significant changes in its services, policies, or procedures so they can decide whether CGL continues to meet the needs of the child. I understand that my signature is valid and legally binding whether I choose to electronically sign, or manually sign a printable version of this document. I have accurately completed the Application and have read, understand and agree to the Terms outlined above. I agree to review all pertinent program materials sent and/or published on CGL’s website, including the Policies for Parents and our Camp COVID policies, and to complete, sign and return all required forms. The parent gives his/her child permission to participate in all CGL activities, including any field trips and programs, and be transported by CGL to and from those activities, unless CGL is specifically informed in writing, before the start of the camp session. I agree that Colorado law (without regard to its conflict of laws rules) governs all aspects of campers' or parents' relationship with CGL, contractual or otherwise, and agree that any lawsuit or legal proceeding will be filed or entered into only (exclusively) in Jefferson County, Colorado. I agree to first attempt to settle any dispute (not settled by discussion) through mediation before a mutually acceptable Colorado mediator. Please complete the information below to electronically sign the CGL Terms of Agreement. If you would prefer to complete and manually sign a printable version of this document, please contact us for a printable version that you can sign and return to CGL via U.S. Mail. Electronic Signature: By typing my name and clicking the ‘I agree’ button, I understand that I am entering into and accepting the CGL Terms of Agreement as a legally binding agreement. I agree to the Terms of AgreementHidden I agree to the TermsQuestions or Comments for us?