Online Registration Form 2009
Things You Need to Know:
Thank you for using online
registration to get started on your
adventure at Misty Hollow.  

Click on the tab above to get
very important information
about the things you need to
know:  Money, Food, Weather,
Safety, Rules, and Personal
Items.  

The following Linked tabs will
provide you with all the printable
forms you need to complete your
registration packet. All forms are
due by May 15th - unless you are
a late registration which is an
additional $50.00 after May 15th.

*** Please print and fill out the
following forms and either scan
& email the completed forms or
mail them to:
Misty Hollow
19061 AL Hwy 157
Moulton, AL  35650

Please make checks out to:
Misty Hollow
Registration Check List
Registration Check List of the  
forms you must return by
May 15th, 2009 to complete your
registration and other details to
keep in mind for your peace of
mind.
Registration Information & Links
Camper Name
You need Java to see this applet.
Today's Date
Name Child Goes
By/Nickname
Age
Birth Date
Male
 Female
Height
 Weight
T-Shirt Size
Y-Sm(6-8)
Y-Med(8-10)
Y-Lg(10-12)
A-Sm
Y-Med
 A-XL
A-Lg
 A-2XL
Please Indicate Which Camp You Would Like To Register For:
Day Camp (5-12)yrs
Explorers' Camp (9-14)yrs
Adventurers' Camp (12-16)yrs
Endurance Expedition Camp (14-17)yrs
Please Indicate 1st Choice, 2nd Choice Camp Session,
or Indicate Director's Choice to Choose Best Session for you.
Adventure Camp Sessions
1st Choice
Session
2nd Choice
Session
Directors' Choice
check here
Mini Camp Adventure Sessions
1st Choice
Session
2nd Choice
Session
Directors' Choice
check here
Growin' Together
Family Camp Sessions
1st Choice
Session
2nd Choice
Session
Directors' Choice
check here
Day Camp (select all that apply)
1st Choice
Session
2nd Choice
Session
Directors' Choice
check here
This Section MUST Be Completed by Legal Guardian Adult
over the age 18 years.
Parent/Guardian Contact Person
Phone
 E-Mail
Mailing Address
Have you read and agree to the Enrollment Terms listed in the
registration packet or linked here? You must agree to enrollment terms
to complete registration by TYPE YOUR INNITIALS.
I agree
 I do not agree
This section must be signed by typing Parent/Guardian Name in the Signature Field
and Dated For our Records.
I, the undersigned, have read and understand the camp's registration information
and enrollment terms.  As part of the consideration for the Camp to accept the above
named child, I give my permission for my child to participate in all structured activities
at Misty Hollow Adventure Camp.  I give permission for Misty Hollow Adventure Camp
and it's staff TO SEEK ANY EMERGENCY MEDICAL TREATMENT DEEMED
NECESSARY IF UNABLE TO LOCATE ME.  I further give permission for the Director of
Misty Hollow Adventure Camp to sign medical and other liability waiver releases on
my behalf in my absence with companies which Misty Hollow Adventure Camp may
"outsource" adventures to.  I understand and accept that my child will be handling live
animals and I further understand my child will be enaged in activities in and around
the vicinity of naturally occurring wildlife and it's habitat and agree to not hold Misty
Hollow Adventures liable or accountable for incidental encounters of such
wildlife/animals.  I further understand and accept that as part of the consideration for
the above named child to attend Camp that HE/SHE will be participating in activities
which may be considered dangerous and the Camp or persons shall not be liable for
any damages whatsoever int the event of injury, illness, or death of said child by any
cause whatsoever, including, but not limited to negligence by the Camp, its directors,
and employees, land owners, lease holders, other campers, other contracted
services therewith and agree to not hold Misty Hollow Adventure Camp or its entities,
directors, employees, land owners, lease holders, or other contracted services
therewith of any such liability, and agree to pay any such damages, and to also pay
any attorney's fees and costs of the Camp if any claim is made against the Camp, its
directors, or employees as included but not limited to parties.
I recognize that this is an educational facility and understand my child may be
exposed to events which may be graphic in nature, such as a live animal birth and
other naturally occurring events.  
I also agree that any photos/videos taken at camp may be used for promotional
materials.  
I also give Misty Hollow Adventures Staff permission to search personal belongings if
they see necessary for the safety or general wellbeing of my child or other campers.
Parent/Guardian Signature
typed signature shall constitute legal signature
Date
EMERGENCY CONTACT PROCEEDURE
SSN
Camper Name
Insurance Provider
Policy #
Name of Insured
KNOWN ALLERGIES
In the event of a serious injury or illness, we will: 1)Administer first aid treatment
2) Telephone the child's doctor for instruction.  In the event the child's doctor
cannot be reached, the Camp will telephone the Camp's doctor choice.
Child's Doctor is
 Phone
Child's Dentist is
 Phone
Responsible person to contact
if parents cannot be reached
Phone
 Cell Phone
I hereby give permission for Misty Hollow Adventures to administer emergency first
aid treatment to my child named, (above).  I further authorize Misty Hollow Adventures
to arrange for professional emergency hospital, medical, or surgical treatment in the
event my child suffers injury or becomes ill while at Camp.  I agree to be responsible
for payment of all hospital and professional medical or surgical treatment rendered to
my child.
Parent/Guardian Signature
type written shall be legal signature
Mother's Name
Cell Phone
Father's Name
Cell Phone
Name of Siblings Attending Camp
Child Lives With?
Emergency Contact Information Including Yourself Who should we contact in order
First to Last with Phone Numbers
Please Note:  All online registrations must be completed by responsible Adult Parent or
Legal Guardian.  Online registration submissions will be received by the day time stamp
and shall be binding as registration for Misty Hollow Adventure Camps.  Online
registrations shall be "signed" by typing in the signature block and shall constitute same
as handwritten Legal Signature.
$35.00 Registraton Fee is Due with application. When sending by mail;
MUST be postmarked within 24 hours of Online Registration Submission.
Registration Form & Quick Reg.
Print and mail or email
completed form back with fees.
Do NOT need this form if you
filled out registration online.
Medical Form
Medical Release forms and
permission to treat forms to be
signed and returned with
completed registration packet
Enrollment Terms
Details of registration, payment,
refund policy, and Assumption of
Risk Policies in effect
Gear List
This is the recommended and
required gear list for camp.  
Brand names may be
substituted for equivalent.
Code of Conduct Agreements
Misty Hollow Code of Conduct
and Personal Agreement must
be signed prior to coming to
camp by parent and child(ren).

FORMS TO PRINT or Download
Release Waiver for Contracted
Services
Gives permission to sign
release waivers required for
contracted activities for White
Water Rafting; Rock Climbing;
and Equestrian Facilities; if such
activity applies for enrolled camp
sessions.  
Copies of such waivers are
available for view on our website
links page.  You may print, sign,
& mail you own waiver if you
would prefer to not participate in
this generalized release.