High School Camp - Session I

Refund Policy: a full refund, minus a $50.00 administrative fee, will be returned if cancellation is received before June 28th, 2013, by 5:00pm.

Camper #1 Information
Parent/Guardian Information
Emergency Contact Information
Insurance Information
Credit Card Information
  1. $300
  2. /
  1. I authorize all medical, surgical, diagnostic and hospital procedures as may be performed or prescribed by a treating physician for the child listed above if I cannot be reached in case of emergency. I understand Northwest University does not assume responsibility for any accidents, medical or dental, or any other expense incurred as a result of attendance at the camp. I hereby certify that the above named camper is physically fit to participate in all camp activities and is covered by health or accident insurance (required for camp attendance).

    Promotion and advertising: all pictures or video taken at camp may be used at the discretion of Northwest University.

    I also agree to the refund policy stated above.

    I agree to these terms.
Northwest University • 5520 108th Avenue NE, Kirkland, WA 98033 • 425.822.8266 • (Enable Javascript to see email address)