Students tide pooling in the San Juan Islands. Seastars:  Pisaster Ocracheus, the Purple Seastar. 2 Students:  Students collaborating at the tide pools . Forest Path:  Old Growth Forest. Boy with Seastar:  Student holding a Seastar. Rosario Beach
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“Can’t wait for next year’s
outdoor ed!” .

Tara, student, Forest Park
Adventist School


Please Print and Mail Form

 - call to reserve space!



What To Bring!

What to Bring!

Academic Adventures P.O. Box 1504, LaConner, WA 98257     360-708-3286

Deception Day Camp Application: Pre-registration required! Call 360-708-3286

Camp Name:_________________________  Camp Dates:______________

Camper Name (please print)__________________________________

Fees:  ______/camper/week               

(Send checks to: Academic Adventures P.O. Box 1504  LaConner, WA 98257)

Credit Card#___________________________Exp:______________

Name as Appears on Card__________________________________

Billing Address for Card_______________________City________St___Zip______

Camper Name (please print)__________________________________

Home Address________________________________City___________St___ Zip______

Home Phone_________________ Parents Cell __Mom __ Dad________________ Work_______________  Email Address*:_________________________________

*Communication for meeting locations will use this email - please verify.

Academic Adventure Camp Guidelines: Parents, please review rules with your camper and sign.

          1.    I will be respectful of camp instructors and fellow campers

              2.    I will be a careful listener and follow directions

              3.    I will stay with my assigned group

              4.    I will have fun!

I have read the Academic Adventures camp rules and I will obey these rules.  I understand that if I do not follow these rules, my parent(s)/guardian(s) may be called to come and pick me up at any time and without refund.

Camper Signature:_________________________ Parent/Guardian Signature________________________

Authorization for alternate parent/guardian Pick-Up

The persons listed below are authorized  to pick my child up from camp.

Name:__________________ Relationship:_____________ Phone# Cell__________________


Name:__________________ Relationship:_____________ Phone# Cell__________________


I understand camp ends at  3:00 PM and will pick up my camper at this time.

Parent/Guardian Signature________________________ Date _____________________

Note: Please Advise Staff of any daily medications that are physician prescribed.


Authorization of Consent to Treatment of a Minor

In the event of a medical emergency this allows medical treatment for your camper.

Camper Name:_________________ Parents Phone #’s   - Home__________________

                                                                                                         - Work___________________

                                                                                                         - Cell____________________

                                                                                                         - Other___________________

I/We, the undersigned, parent/guardian of _____________________, a minor, do hereby authorize Academic Adventures LLC staff, as agent(s) for the undersigned to consent to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is rendered under the general or specific supervision of any physician and surgeon licensed under the provisions of the Medical Practices Act on the medical staff of a licensed hospital, whether or not such diagnosis or treatment is rendered at the office of said physician or hospital.

              It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which the aforementioned physician, in the exercise of his/her best judgement, may deem advisable. 

              This authorization shall remain in effect for one year from this date ____/___/___

Unless sooner revoked in  writing and delivered to said agent(s).

              We hereby give permission for my/our child to attend the Academic Adventures   LLC programs and field trips.  I give the group leaders permission to take any necessary action in the event of an emergency.

Parent Guardian Signature____________________________ Date_________________


Precautions or Activity Restrictions:________________________________________________

Please list any important medical or behavioral history__________________________________ ______________________________________________________________________________

Release of Liability – Accidental Injury

I, _____________________ the parent/guardian of _______________________ hereby acknowledge that my child I freely and voluntarily have chosen to participate in an Academic Adventures LLC program.  I hereby agree to save and hold harmless Academic Adventures LLC, participating private entities, and/or any cooperating or sponsoring public entities and their respective agents from any liability for accidental personal injury or property damage which I or my child may suffer while participating in an Academic Adventures LLC program.  I realize that pictures may be taken at camp by Academic Adventures LLC for memories and/or marketing purposes and hereby give my permission for my child to be photographed.

______________________                    _________________                  ________________

Parent/Guardian (print)                                          Signature                                       Date

  Please tell us how did you hear about the program? ________________________________


  Cancellation Policy - Academic Adventures

   Canceling 60 Days or more before camp - Full Refund

   Canceling 30 - 59 Days before camp - 50% Refund

   Canceling less than 30 days before camp - No Refund

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