Kids Week Out August 23rd - August 27th
This camp allows you to sign your camper or campers up for one, two or all 5 days of camp. This is our more general camp that will have campers experiencing all animals. It will feature guest speakers, games, crafts and so much more! Recommended Ages: 5-10 years old.
Child's Date of Birth:
Camper's T-Shirt Size? (One free t-shirt provided. However, a t-shirt is not guaranteed if registered less than 10 days business days prior to camp start date):
Street Address Line 2
State / Province
Postal / Zip Code
Emergency Contact (if you are not available):
Emergency Contact Phone Number:
Please enter a valid phone number.
Name(s) of those authorized to sign OUT a camper:
Medical Considerations (allergies, physical, or behavior limitations, etc.):
Camp Date Selection
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After Care August 23rd
After Care August 24th
After Care August 25th
After Care August 26th
After Care August 27th
Camp Tie-Dye Drawstring Bag
Credit Card Details
Credit Card Number
Release, Waiver of Liability and Indemnification Agreement.
Please sign the below to accept our terms & conditions.
In consideration for the above child being permitted to participate in Humane Education Camp activities provided by Humane Society of West Michigan, its employees, agents, volunteers, and/or affiliates (collectively referred to as “HSWM”), I agree to the following: I understand that my child will be interacting with unfamiliar animals throughout the term of the summer camps. I certify that there are nonphysical, emotional or mental problems or limitations associated with merchild’s participation in these or any other camp activities. While the Summer Camp animals have been temperament tested by the HSWM and determined to be safe for interaction with the public, animals by their nature are unpredictable. The HSWM will use its best efforts to ensure that interaction between my child and animals is supervised by trained individuals but that the HSWM will have complete discretion in determining how to react in all circumstances including unpredictable animal behavior. I understand that there are unpredictable risks and dangers inherent to interacting with any animal. For myself and my child, I acknowledge and assume the risks involved in these inherently dangerous activities, and for any damage, illness, injury or death resulting from such activities. I certify that I have the authority to enter into this agreement on behalf of my child and release and waive any claims that I or my child may have against the HSWM with respect to any loss, injury, illness, damage or death occurring to my child while he/she is in the custody and care of HSWM as well as any related claims that I may have. I agree to indemnify and hold harmless the HSWM from and against any and all liability and costs (including attorney fees)related to any such claim asserted against HSWM by or on behalf of my child or me. I agree that this release, waiver of liability and indemnification agreement is intended to be as broad and inclusive as permitted by the laws of the state of Michigan, and that if any portion thereof is held invalid, it is agreed that the balance shall notwithstanding continue in full legal force and effect. In event of accident or injury to my child, I authorize the HSWM to make whatever transportation, diagnosis and/or treatment arrangements as they, in their sole discretion, deem to be appropriate in the circumstances. I agree that my insurance or I personally will be liable for any costs incurred for the transportation, diagnosis and/or treatment of my child. I understand that the HSWM will make a reasonable effort to contact me at the phone number(s) listed below and to honor any other health care requests indicated below but that the transportation, diagnosis and/or treatment of my child will proceed whether or not I can be contacted. I grant HSWM the right to use my name, portrait, photograph, video segment or other image, and those of any minor named below, on whose behalf I am signing, for marketing, public relations and/or educational purposes. I grant HSWM the right to use the name or image described above in print, video and/or electronic media. I understand that HSWM retains all rights to use, publish or distribute the portraits, photographs, video segments or other images and has the right to do so without seeking any further permission from me or providing me any royalty. I ask that the HSWM use reasonable efforts to give me advance notice of any such use, but such notification is not a condition to HSWM’s use or publication of my name or image for marketing, public relations and/or educational purposes. I understand that full refunds may only be provided with two week’s full notice of cancellation, prior to your scheduled attendance, minus a $20 processing fee. I understand that refunds will not be provided without notice of cancellation and that refunds cannot be provided during the scheduled week of camp. Please Note: Please understand that animal time during camp may be limited or varied depending on the day and the camp based on what animals we have at the time. Shelter animals are in an extremely stressful environment and we want to make sure we are providing the campers and animals with a safe and enriching experience free of harm and stress. We appreciate your patience and understanding as we all strive to provide shelter animals and campers a safe environment. I HAVE READAND UNDERSTAND THE ABOVE AND AGREE TO BE BOUND BY THE TERMS OF THIS DOCUMENT.
Please review this information with your child (all children regardless of age!) and have them sign below.
I understand that I am here to learn more about Humane Society of West Michigan and how to be a responsible, caring friend to animals. I will do my best to follow instructions and to act in such a way as to protect the animals and the people around me. I also agree to behave myself in a responsible way. I understand the discipline policy. Discipline Policy a. Disciplinary action may be taken if a camper displays behavior that disrupts the camp program. Examples of this behavior include inappropriate language, making fun of or insulting others, bullying, using profanity, harming or frightening the animals, physically harming others, not following directions or actions that make other campers feel uncomfortable. b. Consequences for undesirable behavior: i. First offense- verbal warning from staff. ii. Second offense- partial removal from activity; follow up with parent/guardian. iii. Third offense- sent home and meet with parent/guardian. iv. Fourth offense- Removal from camp; no refund given. If my behavior is a danger to the animals, other campers or anyone else at Humane Society of West Michigan, no warning will be given, and I will be sent home immediately. Campers Signature Below:
Should be Empty: