Register for Cub Camp

Student Information


Contact Information


Camp Options

Select Your Camp Level*
Cub Camp Lunch ($30)*

Course Selection (Grades 1–8)


Emergency Medical Information

My child has the following medical condition(s):

Emergency Contacts


The following people have my permission to pick up my child from Cub Camp:


Parental Consent & Release

The undersigned, as parent or guardian of the child named above, consents that my child participate in Shawnee State University’s program Cub Camp. I acknowledge that the child named is a minor under the age of 18. I grant permission that any pictures taken containing my child may be used for future promotional purposes.

I acknowledge that the program includes indoor and outdoor activities of the nature that may expose the child to hazards or risks that may result in illness, personal injury or death. I understand and appreciate that nature of such hazards and risks.

Although a minor, my child is aware of the risks involved in participating in the program. I assure Shawnee State University that I have carefully counseled my child on the risk of participating. Further, I assure Shawnee State University that there are no physical or other reasons that preclude my child from participating in the program.

I authorize Shawnee State University that I have adequate health insurance or personal funds to provide payment for all costs of medical necessary for my child. I agree to indemnify and hold harmless Shawnee State University for any costs associated with such care.

I agree that all the requirements, directions and standards set by program staff, use of any equipment or supplies under the supervision of the staff, shall be deemed to have been accomplished for the benefit of my child.

In the consideration of Shawnee State University’s efforts on my child’s behalf, I do hereby voluntarily assume all risk of accident, injury, damage and/or loss of my child’s property that may arise out of my child’s participation in Cub Camp, hereby intending to release and discharge Shawnee State University, its board of Trustees, officers, employees and agents associated or connected with the program from every claim, liability or damage of any kind caused by negligence of Shawnee State University, its board of Trustees, officers, employees or agents involved or otherwise that may result from my child’s participation in Cub Camp.

I have read and agree to the terms of Parental Consent & Release**