Game Master's Getaway Registration

Game Master's Registration

March 28-29; Registration Starts at 4pm and Dinner at 6pm; $75 per person
Name*

First NameLast Name
Birthday*

MonthDayYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Are you registering other people besides yourself?*
How many rooms will you need to reserve? (rooms can hold up to 8 people; please bring bedding-twin xl)*
Name

First NameLast Name
Birthday

MonthDayYear
Date
Name

First NameLast Name
Birthday

MonthDayYear
Date
Name

First NameLast Name
Birthday

MonthDayYear
Date
Pay NowPay Upon Arrival

Liability Form
Consent to Release Liability

I understand that there are certain inherent risks in any activity, including challenge course involvement. In consideration of my and/or my child(ren)’s participation in these activities, I, for myself, spouse, and heirs, agree to release Northland and any affiliate partners from any and all claims, demands, or actions on account of damage to personal property or injury which may result from participation in any activity and challenge course activities. This release includes claims based on the negligence of Northland and their staff, but expressly does not include claims based on their intentional misconduct or gross negligence. I understand that by agreeing to this clause I am releasing claims and giving up substantial rights, including my right to sue.

Consent to Release of Information

I consent to the release of health information, including diagnoses, medications, mental health, communicable disease status, treatments, and laboratory findings, to any medical staff as deemed necessary by Northland for the safety of myself, my child, and/or and others. Northland reserves the right to review and use this information to assess camper capability and implement appropriate safety precautions.

Consent to Emergency Examination and Treatment

I understand that every effort will be made to contact parents or guardians or participants in the event of an emergency. In the event that I and/or an emergency contact cannot be reached, I hereby give permission to the physicians selected by Northland to hospitalize; secure proper treatments; and order injection, anesthesia, or surgery for myself and/or my child(ren) as named. I consent to examination and treatment of myself and/or my child(ren) through Northland Health Center personnel employed by Northland Mission, Inc. (Northland). I assume all financial responsibility for such treatment.

Consent to Use of Likeness and Sending of Information

For promotional purposes, Northland Camp & Conference Center reserves the right to use any photography or video taken while you and/or your child is at our facility. Northland Camp & Conference Center reserves the right to send you and/or your child information, including promotional materials.
By signing your name, you consent to the following: I have read the above Liability Form and agree to its terms on behalf of myself and those listed on this registration. I understand that by signing below, I am consenting to the above agreements on behalf of myself and those listed on this registration.*

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Game Master's Registration

Liability Form