NFB Camp Registration Form

The costs for convention camp vary. You can register your child for the week or on a daily basis. Registering your child for the week will allow you to register siblings at a reduced weekly rate. You may also register your child for camp during banquet for an additional fee.

Weekly Rate: $100 for the first child, $75 for each additional sibling. This fee does not include banquet.
Per Day: $25 per child per day. This fee does not include banquet.
Banquet Evening: $25 per child.

Camp Hours
Sunday, July 7th: 8:30 AM–12:30 PM and 1:30 PM-5:30 PM
Monday, July 8th: Camp is closed.
Tuesday, July 9th: 8:30 AM–12:00 PM and 12:45 PM–5:30 PM
Wednesday, July 10th: 9:00 AM–12:30 PM and 1:30 PM–5:30 PM
Thursday July 11th: 8:30 AM–12:30 PM and 1:30 PM–5:30 PM
Friday, July 12th: 8:30 AM–12:30 PM and 1:30 PM–5:30 PM
Banquet: 6:30 PM–30 minutes after adjournment.

Upon competion of the online registration and disclaimer package you will receive an email copy of your responses. Please print, sign, and date the entire package. Enclose your fees with the signed copy and send to:

NFB Camp
5005 Main Street
Springfield, OR 97478

Completed form and fees must be received on or before June 15, 2018. Please make checks payable to NFB Camp.

Please take a few minutes to read the NFB Camp Rules.

Required field(s) are indicated by an *.

Parent/Guardian Information

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Address 1: *

Address 2: *

City: *

State: *

Zip Code: *

Phone Number: *

Email Address: *

Child(ren) Information

Please select the number of children you wish to register in camp. *

First Child:

Child's First Name: - Optional

Child's Last Name: - Optional

Child's Date of Birth: - Optional

Child's Age: - Optional

Snack Preference: - Optional

List all allergies and medical conditions we should be aware of. - Optional

Second Child:

Child's First Name: - Optional

Child's Last Name: - Optional

Child's Date of Birth: - Optional

Child's Age: - Optional

Snack Preference: - Optional

List all allergies and medical conditions we should be aware of. - Optional

Third Child:

Child's First Name: - Optional

Child's Last Name: - Optional

Child's Date of Birth: - Optional

Child's Age: - Optional

Snack Preference: - Optional

List all allergies and medical conditions we should be aware of. - Optional

Programs and Cost

Please choose from the camp options below.

Are you interested in registering your children for weekly camp? *

Weekly Camp

Please enter the number 1 for the primary child you are registering in the weekly camp. - Optional

Please enter the number of additional children you would like to register in weekly camp. - Optional

Primary child fee: - Optional

Are you interested in registering your children for daily camp? *

Daily Camp

Please enter the number of children you are registering for daily camp. - Optional

Please enter the number of days you are registering your children for daily camp. - Optional

Per Day Fee: - Optional

Please select the days you would like to bring your child(ren) to daily camp. - Optional

Sunday, 7/7

Tuesday, 7/9

Wednesday, 7/10

Thursday, 7/11

Friday, July 12

Are you interested in registering your children for banquet camp? *

Banquet

Please enter the number of children you would like to register for banquet evening camp. - Optional

Banquet Evening Fee - Optional

Total Camp Fees Due: - Optional ({primary_child_weekly}*{primary_child_fee}) + ({additional_children_weekly}*{additional_weekly_children_fee}) + ({number_of_children_for_daily_camp}*{number_of_days_for_daily_camp}*({per_day_fee})) + ({number_banquet_evening_camp_registrants}*{banquet_evening_fee})

Waiver of Responsibilities

The undersigned do(es) hereby release and discharge THE NATIONAL FEDERATION OF THE BLIND, INC., and any of its agents, affiliates, employees or servants from any and all claims, liabilities, demands or rights which I(we), or any friends or relatives, may have or against said Corporation or any of its agents, affiliates, employees or servants on account of, connected with or growing out of any injury, accident, loss, damage or suffering, I(we) may hereinafter sustain while on the premises or property owned, leased or used by THE NATIONAL FEDERATION OF THE BLIND, INC., or any other named designation or location. I(we) have read, or cause to be read to me(us), the foregoing and do hereby acknowledge that I(we) fully understand each and every part thereof.

Waiver Response *

Initials: *

In the event of an emergency, NFB Camp has my permission to call an ambulance or take my child(ren) to any available physician or hospital at my expense and to obtain medical treatment for my child(ren). In most emergencies, 911 is called and the child is transported to the nearest hospital and seen by the Doctor on call. (Parents are always notified as soon as possible). This permission is effective the date this form is signed and continues for the duration of my child(ren)'s enrollment at NFB Camp.

Medical Release

Medical Release Response *

Initials: *

I understand that there may be an occasion while in the care of NFB Camp that photographs of my child(ren) may be taken. I hearby give my permission for these photographs to be used as the National Federation of the Blind deems appropriate for publicity purposes.

Media Release

Media Release Response *

Initials: *

Camp Rules

If you have not already done so, please read the camp rules at:

https://nfb.org/camp-rules

Camp Rules Response: *

Initials: *