Discovery Days at the 1719 Museum: Celebrating Culture through Craftsmanship

A weeklong day camp for youth age 11-15

Participants will explore 17th and 18th century Indigenous and Swiss-German cultures of Lancaster through inquiry-based learning, storytelling, and activities. The program will run from June 9–13, 9:00 a.m.–12:00 p.m. at the 1719 Museum.

Participant Information

Child's Name(Required)

First Last

Child's date of birth(Required)

Parent/Guardian's Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City ZIP Code

Emergency Contact #1

Name(Required)

First Last

Relation to Child(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact #2

Name(Required)

First Last

Relation to Child(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Transportation

Please list the person(s) authorized to pick up your child after camp activities, or in case of emergency.

Name(Required)

First Last

Relation to Child(Required)

Name

First Last

Relation to Child

Name

First Last

Relation to Child

Health/Allergy information

Please list any health/allergy information museum staff should be aware of.

Additional comments or questions

Your Comments/Questions

Liability Statement & Photo Release

Liability Statement(Required)

By submitting this form, I hereby take action for my myself, my dependant child(ren), my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for the death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me and/or my dependant child(ren) taking part in the Discovery Days program, THE FOLLOWING ENTITIES OR PERSONS: Mennonite Life and/or their directors, officers, employees, volunteers, representatives, and agents; (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in activities on the property at 1849 Hans Herr Drive, Willow Street, PA, 17584, whether caused by the negligence of release or otherwise.

Liability Statement(Required)

I give my consent to have my child treated by emergency personnel in case of sudden accident or injury.

I am the child's legal guardian and I hereby grant Mennonite Life the right to take photographs or videos of my child in connection with my child's participation in the activities. I hereby authorize Mennonite Life to copyright, use, and publish the same in print and/or electronically, and use for any lawful purpose, including but not limited to publicity, illustration, advertising, and Web content.(Required)

Yes

Registration costs

The registration cost for this camp is $150/camper. The entire week is included in this price. No refunds will be given for missed sessions. You will receive an invoice with a link to pay within two business days of completing this form. Payment is due by Friday, May 23.