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Mount Clemens Registration Form

Leadership Academy Registration Form - Mt. Clemens

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  • Emergency Contacts

    Please list 2 different people that could be contacted in case of an emergency.
  • Participation Consent

    I give permission for my child/children to participate in the CARE Summer Leadership Camp in Mount Clemens. I understand that my child will be required to complete a pre/post evaluation for the camp and that the purpose of this evaluation is to help CARE staff demonstrate that the program is effective and impactful for the participating youth.
  • Social Media Release

    I grant CARE of Southeastern Michigan the absolute and irrevocable right and unrestricted permission concerning the use of photographs that may be taken which may include with others, to use, reuse, publish, the photographs in whole or in part, individually or in connection with other materials. I release and discharge photographer from any and all claims that may arise out of or in connection with the use of the photographs, including without limitation any and all claims for liable or violation of any right of publicity or privacy.
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