Clone of iStrive Hmong Summer Camp

iStrive Hmong Summer Camp Registration
This registration form is to register your child(ren) for the 2 Week Camp only. One registration form per child.

Camp dates - August 3rd, 2026 - August 14th, 2026
Free Reduced Lunch Scholarship IS FULL.

We are no longer accepting applications for free reduced lunch scholarships at this time.
Student First Name
Student Middle Name
Student Last Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date

MonthDayYear
Race of Child

Other
Gender
School attended (2025-2026)
School District
Grade Level (2025 -2026 School Year)
Did your child attend iStrive Camp in the past years?
T- Shirt Size
Transportation Plans (Please see transportation map before selecting for bus on the FAQ sheet)
If parent pick-up, will there be anyone else picking up your child from iStrive Camp? If yes, please list authorized pick-up person and phone number.
For bus, is there an alternate address your child(ren) will need to be picked up/dropped off at? If yes, please list the full address below and details around the situation.
Is there anything we need to know about your child's transportation plan? i.e. starting camp late due to vacation, drop-off at cousin's house in the PM, etc....
Are there special conditions for your child that the staff needs to know, if so please describe in the section below? If you have any concerns about your child, please email istrivecamp@gmail.com
Does your child have any food allergies, if so please list them below (be specific - gluten, dairy, fruit, peanuts, fish, etc...)
Does your child have any other type of allergy, if so please list them below (be specific - grass, dust, pollen, etc...)
Does your child have any doctor prescribed medication that needs to be taken during the hours of 8:00 AM - 3:00 PM? If so, please describe what kind of medication, frequency needed, and/or any other details we need to know about the medication. We will require that the parent provides the prescription of the medication to evaluate the medication.
Does the medication need to be refrigerated?
Parent/Guardian Information
Parent/Guardian Name

First NameLast Name
Cell Number
Format: (000) 000-0000.
Work Number
Format: (000) 000-0000.
E-mail
example@example.com
What is your combined household annual income?
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Do you opt in into receiving information about future programs, opportunities, and information about MN Zej Zog?
iStrive Hmong Camp is a community initiative and would not happen without all the hands supporting the program. We are always looking for parent engagement and volunteers, are you interested in volunteering? If so, what is your availability?
Is there anything else that we need to know about your child(ren)?
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by iStrive Hmong Camp during the selected camp. In exchange for the acceptance of said child’s candidacy by iStrive Hmong Camp. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless iStrive Hmong Camp and all its respective Administrators, Teachers, Facilitators and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

2 Week Program from Mon - Fri: August 3rd - August 14th from 8:30 AM - 1:00 PM

In case of injury to said child, I hereby waive all claims against iStrive Hmong Camp including all aministrators, teachers, facilitators, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities or in the case of an accident.

In the past two years, students have done damages to the North Hennepin Community College; therefore, I also acknowledge in case where damage is done to the property of North Hennepin Community College by my child that I will be notified. The child could be expelled from the camp and/or I may pay the cost of fixing the damages done. I will be informed by the iStrive Camp Administration if this is the case.

Medical Release and Authorization

I understand that in the event of an emergency affecting my child while participating in iStrive Hmong Camp at North Hennepin Coummunity Collage, a designated employee of iStirve will attempt to contact me and inform me as soon as possible. In the event I cannot be reached, I hereby give permission for my child to be trreated or hospitalized by a licensed physician or hospital selected by MN Zej Zog.
Photo and Media Release

At iStrive Hmong Camp there will be photography and video on the premises of the camp. Photos and video may be used for media coverage and/or promotional purposes. In additon, as a new feature to keep parents informed and a great way for families to see what is happening at iStrive Hmong Camp, iStrive will be posting occassional photos on the iStrive Hmong Camp Facebook Group page. By completing this registration, I hereby consent to the terms above.

Refund

If your child will not be attending camp, you can request for a refund by July 27 by emailing istrivecamp@gmail.com. If your child(ren) attends the camp, you will no longer be eligible for a refund. Refund will be the camp cost minus the Jotform processing fee. Refunds will take 4 to 6 weeks.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Signature
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2 Week Camp Registration

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iStrive T-Shirt Purchase

T-Shirt cost + Processing Fee

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iStrive Hmong Summer Camp Registration

This registration form is to register your child(ren) for the 2 Week Camp only. One registration form per child.

Free Reduced Lunch Scholarship IS FULL.

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