CAMP POLICIES Click to learn about our Camp Policies & fill out the form below to register. One form for each child. Please enable JavaScript in your browser to complete this form.Camper InformationCamper's Name *FirstLastCamper's School *Select Grade Entering: *- Please select -1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th GradeBirthdate *Please select the camp(s) your camper would like to attend *Lets Get Creative! (June 3-7) ages 9-13 as of June 1Rising Rangers (June 17-21) ages 9-13 as of June 1Young Naturalist (July 8-12) ages 6-9 as of June 1Surviving the Settlement of Evergreen (July 15-19) ages 9-13 as of June 1Appalachian Creation (July 29- Aug. 2) ages 9-13 as of June 1*Minimum number of campers are required to hold camp Parent/Guardian Contact InformationParent or Guardian Name *FirstLastSecond Parent or Guardian Name FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Secondary Phone NumberEmail *Secondary EmailCamper's t-shirt size *- Please select -Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeRegistration includes a camp t-shirt. Registration after May 5 will not guarantee selected shirt size Do you give permission for Photo/Audio/Videos of your camper? *- Please select -YesNoBy giving consent to photo release, Evergreen Heritage Center may use your child's photo/audio/videos in promotional material & social media posts. Medical InformationDoes your child have any medical conditions?Child wears glasses or contactsChild has asthmaChild has asthma inhalerChild takes daily medicationChild has allergiesChild carries an epi-penChild has ongoing illness that would impact participationChild has special dietary restrictionsPlease explain any items checked:Doctor's Name *Doctor's Phone Number *Date of last Tetanus (DTP/DPAP) shot *Emergency Contact InformationEmergency Contact *FirstLastRelationship to the Camper *Phone Number (during camp hours) *Person(s) Authorized to Drop-off/Pick-up Child Daily *Is there any additional information you would like us to be aware of?Signature *Clear SignatureI, the parent/legal guardian of the child named above, give my permission for him/her to participate in EHC Summer Camp program. I assume all risks and hazards incidental to such participation including transportation to and from site which is located 15603 Trimble Rd NW, Mt Savage, MD 21545. In the event of an emergency requiring immediate medical attention, my child will be taken to the UPMC Western Maryland Emergency Room. My signature above authorizes EHC Summer Camp staff to have my child transported to the UPMC Western Maryland ER in the event it is deemed necessary by the staff. I do hereby waive, release, and hold harmless the Evergreen Heritage Center Foundation from any claim arising out of injury during this program. I have read and understand the EHC Camp Policies.Payment options: cash, check, credit card *Cash- Contact 301-687-0664Check- make payable to: Evergreen Heritage Foundation 101 Braddock Hts, Frostburg, MD 21532-2345Credit Card- Use payment buttons belowRegardless of your payment option or if you wish to be selected for a scholarship, you must still click submit and close out the payment page.PaymentEarly Bird Special (before April 30) - $270.00One Week of Camp - $300.00Two Weeks of Camp - $540.00Three Weeks of Camp - $810.00Four Weeks of Camp - $1,080.00Camp Scholarship (Must be approved prior to registration) - $40.00$40.00 non-refundable registration fee and multiple camp discount are included in the pricing above. Once you click Submit, you will be redirected to the payment page. Submit