Registration Form
Parents name
*
First Name
Last Name
Campers Name
*
First Name
Last Name
Camper #2
First Name
Last Name
School
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Age
*
Please Select
10
11
12
13
14
15
16
17
18
Age #2
Please Select
10
11
12
13
14
15
16
17
18
Camper Number
*
Format: (000) 000-0000.
Camper Number #2
Format: (000) 000-0000.
Sweater size
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Please Select
Small
Medium
Large
X-Large
Sweater size #2
Please Select
Small
Medium
Large
X-Large
Parents Number
*
Format: (000) 000-0000.
Rates & Packages
*
Summer $3,995 [June 29-Aug 20]
First month $2,250 [June 29- July 19]
Second Month $2,250 [July 21-August 15]
Daily $165
Friday Drop in $150
Pre- Camp $550 [June 22-26]
Post Camp $550 [August 24-28]
Address (Deal)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred payment method:
*
Cash
Check
Zelle -(347-404-4586)
Venmo- Esther-Katach
LIABILITY RELEASE WAIVERSHTEIG AND SURF CAMP LLC / WAVES OF HESSED - RELEASE OF LIABILITY, WAIVER, AND ASSUMPTION OF RISK AGREEMENTCAUTION: DO NOT SIGN THIS DOCUMENT WITHOUT READING IT IN ITS ENTIRETY AND CAREFULLY. BY SIGNING THIS DOCUMENT, YOU GIVE UP IMPORTANT LEGAL RIGHTS! SURFING IS AN ATHLETIC ACTIVITY, THE PARTICIPATION IN WHICH INVOLVES VARIOUS RISKS. PLEASE READ AND UNDERSTAND THIS DOCUMENT.THIS IS A LEGAL DOCUMENT. MY E-SIGNATURE IS MY ACKNOWLEDGMENT OF THE CONTENTS OF THIS CONTRACT. I WILL NOT SIGN THIS DOCUMENT UNLESS I FULLY UNDERSTAND AND AGREE TO BE BOUND BY ITS CONTENTS.I, Name of Parent/Guardian* , the parent or legal guardian of Name of Participant*that is signing this document, acknowledge that:1) My Child Knows How To Swim And To Maintain Buoyancy In Open Water, And Is In Good Health: Her swimming skills are above those of a novice and she can maintain her head above water when his feet do not make contact with the bottom for extended periods of time. Likewise, she is in good physical and mental health, he is not under the influence of any drugs, alcohol, or other substances which may impair his swimming skills or his ability to take and follow instructions. She is not suffering from any spinal or skeletal defect, hearing, vision or balance impairment or other physical impairment. I understand that the foregoing representations as to his physical condition are being relied upon by Shteig and Surf Camp LLC / Waves of Hessed. I hereby agree to follow all rules, regulations, and instructions of Shteig and Surf Camp LLC / Waves of Hessed while participating in this class, lesson, or while renting equipment from Shteig and Surf Camp LLC / Waves of Hessed. 2) I Acknowledge That Surf May Be Dangerous And I Accept And Assume Such Risk: I am aware that open water activities in general, and in surf specifically, involves inherent risks. I may damage my belongings, get hurt, get injured, become ill, drown, or even die.I further acknowledge that I have voluntarily chosen to take surfing lessons from Shteig and Surf Camp LLC / Waves of Hessed, or if the individual taking such lessons or renting equipment is a minor. I have, as the minor’s parent or legal guardian, voluntarily consented to such minor taking of such lessons, or renting equipment. I know and fully understand that water sports in and around surf are dangerous outdoor activities in an uncontrolled natural environment with inherent risks and hazards, where serious accidents can occur, participants can sustain property damage, injuries, illness and even die. I acknowledge and willingly and voluntarily assume all risks and hazards in surf and beach related activities in all phases of these activities from the training sessions until the conclusion of the class, lesson, or equipment rental period, including, but not limited to those involving, (1) loss of control of the surfboard or other equipment, malfunction of the surfboard or other equipment, falls from the surfboard or other equipment, collision with other participants, equipment, other surfboards, rocks, and any other man made or natural obstacles, whether obvious or not; (2) judgment, decision making and conduct of the instructors; (3) submersion in water, drowning; (4) encounters with animals, marine life, plant life, rocks and insects; (5) exposure to outdoor ocean environment, bacteria or microbes, extreme temperatures, sun, and inclement weather, including travel by foot or vehicle in any way related to this activity; (6) assistance in lifting and/or carrying surfing equipment; (7) rescue-related injuries; and (8) unavailability of immediate and appropriate medical attention in case of injury. I understand and acknowledge that the above list is not meant to be complete or exhaustive; that other unforeseen and unanticipated risks, known or unknown, may also exist and result in damage, injury, illness, disease, or death.3) I Waive My Right To Sue Shteig and Surf Camp LLC/Waves of Hessed : In consideration for Shteig and Surf Camp LLC /Waves of Hessed agreeing to provide me with equipment rental or surfing instructions and/or allowing me to participate in this class or lesson, I agree that I shall not make a claim or bring any action against, sue, or hold responsible, the Borough of Deal, its employees and other agents, Shteig and Surf Camp LLC /Waves of Hessed , Esther Katach, its owners (including Nathan Shamie), officers, agents, employees, associates, representatives, (referred to collectively in this agreement as “Shteig and Surf Camp LLC/Waves of Hessed ”) or expect, require, or pursue them, to be held accountable for any damages. I voluntarily agree to release, discharge, and hold harmless Shteig and Surf Camp LLC / Waves of Hessed from and against any and all claims of liability, even those arising out of their negligence, fault, recklessness, or any other act or omission which causes me damages, property damage, illness, personal injury, disease, or death, of any nature in any way connected with my participation in this activity. I also expressly agree to release and discharge Shteig and Surf Camp LLC / Waves of Hessed from any act or omission, excluding acts of wanton or gross negligence, in rendering or failing to render any type of rescue, emergency or medical services.4) Indemnity: I further agree, to hold harmless, defend, and indemnify Shteig and Surf Camp LLC /Waves of Hessed and the Borough of Deal from all defense costs, including attorney’s fees incurred in connection with any claims arising from the activities anticipated herein, including but not limited to those for bodily injury, wrongful death, or property damage, whether caused by or sustained by any minor under 18 years of age on whose behalf I am signing, or which I may have caused to spectators or other third parties, whether negligent or not, in the course of my participation in this activity. 5) Permission to Obtain Medical Assistance: In the event of any injury, illness, emergency, accident or other harm sustained by me (or by the minor on whose behalf I am signing this document), I hereby give Shteig and Surf Camp LLC / Waves of Hessed permission to obtain Medical Assistance, in which event I hereby make the same releases and waivers in Shteig and Surf Camp LLC's / Waves of Hessed’s favor as I have otherwise made in this agreement in connection with any such medical assistance sought or not sought. In addition, the expenses for any such medical emergency shall be my sole responsibility and not that of Shteig and Surf Camp LLC / Waves of Hessed. 6) I HAVE READ THIS DOCUMENT IN ITS ENTIRETY AND IT IS MY INTENTION THAT IT BE BROADLY CONSTRUED IN FAVOR OF SHTEIG AND SURF CAMP LLC/ WAVES OF HESSED IN THE EVENT OF ANY AMBIGUITIES, WHICH SHALL BE RESOLVED IN SHTEIG AND SURF CAMP LLC’S / WAVES OF HESSED’s FAVOR. I UNDERSTAND THAT I AM ASSUMING ALL THE RISKS INHERENT IN THIS SURFING ACTIVITY, AND THAT I MAY BE INJURED, BECOME ILL, OR EVEN DIE AS A RESULT OF SURFING. I UNDERSTAND THAT THIS IS A RELEASE OF ANY AND ALL CLAIMS. I UNDERSTAND THAT THIS IS THE ENTIRE AGREEMENT BETWEEN ME AND SHTEIG AND SURF CAMP LLC / WAVES OF HESSED , AND THAT NO REPRESENTATIONS HAVE BEEN MADE TO ME BY SHTEIG AND SURF CAMP LLC/ WAVES OF HESSED OUTSIDE OF THIS AGREEMENT. I VOLUNTARILY SIGN MY NAME AS EVIDENCE OF MY ACCEPTANCE OF ALL THE PROVISIONS IN THIS RELEASE AND MY AGREEMENT TO BE BOUND BY THEM.
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