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Blue Mountain Ranch
Summer camp for Boys & Girls
20115 CamPer Application
Thank you for taking the time to fill this form out online. We look forward to a great summer!
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Indicates required field
Camper's Name:
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First
Last
Camper's Sex:
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Male
Female
Height
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Weight
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Years at BMR
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1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
Camper's Age:
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7
8
9
10
11
12
13
14
15
16
17
18
Date of Birth (MM/DD/YEAR):
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School Now Attending:
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Grade
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First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
Freshman
Sophmore
Junior
Senior
College
School Reference:
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Personal Reference:
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Mother's Name:
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First
Last
Mother's Occupation:
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Father's Name:
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First
Last
Father's Occupation:
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Parents are:
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Married
Separated
Divorced
Mother Deceased
Father Deceased
If divorced, who is the custodial parent?
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If Parents are divorced, please fill out the custody form and inform us of any special instructions especially regarding visitation and/or pick up from camp.
My child can...
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Swim
Ride Horseback
Musical Instruments Played:
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Home Phone:
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Mother Cell:
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Mother's Work:
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Mother's Email:
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Father's Cell:
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Father's Work:
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Father's Email:
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What are his/her hobbies or special interests?
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Choose 3 Activities you would like your child to experience at camp
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Horseback Riding
Hiking
Fishing
Swimming
Canoeing
Archery
Riflery
Arts & Crafts
Nature Study
Camp Rodeo
Horse Care
Football
Tennis
Cooking Class
Yoga
Creative Writing
Drama
Track
Cheerleading
Ropes Course
Soccer
Volleyball
Basketball
Weight Lifting
Rappelling
Baseball
Mountain Climbing
Physical infirmities or special habits?
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What do you most desire your child to accomplish at camp?
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Religious Affiliation:
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Additional Information about your child:
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Where did you first hear about BMR?
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Names & Ages of other children in family:
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Names & addresses of friends you would recommend for camp:
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Camp Sessions:
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1st Term: June 13-June 28 (16 days) $2350
2nd Term: June 30-July 24 (25 days) $3200
3rd Term: July 26-Aug. 10 (16 days) $2350
Combination of Two Terms $4800
I prefer to pay a deposit of $200 for each term and the balance by May 1, 2015:
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Online Payment
Sending a Check
Blue Mountain Ranch is not responsible for campers while they are traveling to and from camp.
Blue Mountain Ranch is not responsible for loss of personal equipment by fire, theft, water damage, or carelessness of camper. The camp will provide every reasonable safeguard for the health and safety of each child. However, in the event of accident or illness, parents will pay all expenses. Parents will be billed for any prescriptions or medicines required. In case of early departure due to illness or accident, loss of remaining camp fee will be shared equally between camp and parents.
Parents should not take camper out of camp. Health, happiness, and personal accomplishments in camp are better for campers who do not leave camp, even with parents. Special trips to Colorado Springs on medical, optical, and dental matters, or to meet late arrivals or arrange for early departures, are at extra expense both for transportation and supervision at $.20 per mile (round trip to Colorado Springs is 70 miles).
No reduction will be made for late arrivals or early departures of terms enrolled for, regardless of reason. The value of the camping experience is minimized by either late arrival or early departure for the camp term.
In signing application, the parent certifies that the child is in good, normal health, has no abnormal tendencies, and would make a desirable companion for other children. It is understood that the Director reserves the right to refuse any applicant without stating reason, and to dismiss any camper whose influence is not good for our organization.
The parent also gives permission for his/her child to participate in all camp activities, including field trips, unless otherwise noted below.
Agreement to Terms and Conditions:
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I have read and agree to all the terms and conditions stated above on this application. By signing my name digitally, I understand that this is a binding agreement with Blue Mountain Ranch.
Signature of Parent/Guardian
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Date of Signature:
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Submit Application