2023 Rogers Explorers Acceptance

Rogers Explorers Acceptance Paperwork

Rogers Explorers Acceptance Paperwork

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2023 Rogers Explorers Acceptance Paperwork

Below is the 2023 Rogers Explorers Acceptance Form

Please read this form carefully before submitting as it includes information regarding medical care and rules and regulations for camp.

Please submit the form by the April 14th deadline. If you do not fill out the form by the deadline, you will forfeit your position in the program.

There are 8 sections on this form. Be prepared for the following:

-Section 1: Contact Information - Your basic information

-Section 2: Parent Information - You will need emergency contact information

-Section 3: Important Note to Parent(s)/Guardian(s)

-Section 4: Code and Conduct

-Section 5: Media Release

-Section 6: Health Insurance and Release Form: Upload a front and back copy of your health insurance card.

-Section 7: Community Service

-Section 8: Camp Choice

Section 1: Contact Information

County of School *

First Name *

Last Name *

Please list your preferred name if different from your legal name. This will go on your name badge.

School Name *

Date of Birth *

Shirt Size *

Student Email Address *

Please use an email that you check on a regular basis.

Parent/Guardian Email Address *

Please use an email that you check on a regular basis.

Mailing Address *

City *

State *

Zipcode *

Acceptance into the Rogers Explorers Program

YES! I accept my selection as as a Rogers Explorer.

No, I will not be able to participate. If this is the case, please do not fill out the rest of the form and call Amber Decker at 606-677-6019.