UES Spring Class Registration Form

Registration Form For Spring Classes
Caregiver Name*

First NameMiddle NameLast Name
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
Family member 1

First NameLast Name
Birth Date

MonthDayYear
Family member 2

First NameLast Name
Birth Date

MonthDayYear
Family member 3

First NameLast Name
Birth Date

MonthDayYear
Family member 4

First NameLast Name
Birth Date

MonthDayYear
What county are you located in?*

Select Class
Please carefully select which course & date you will be attending. You can find information about each specific class on our website, www.unboundearthschool.org/programs *

Emergency Contact Information
Emergency Contact 1 Name*
Emergency Contact 1 Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2 Name*
Emergency Contact 2 Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Waiver

Please read carefully and sign below
Unbound Earth School, LLC RELEASE & HOLD HARMLESS WAIVER OF LIABILITY AND INDEMNITY AGREEMENT 2024-2025 By signing this form, I hereby voluntarily agree to release, waive, and fully discharge Unbound Earth School, LLC from any and all claims, demands, obligations and liabilities of any kind or nature whatsoever arising from or connected, directly or indirectly, with my/my children's participation in the outdoor activity program due to any cause whatsoever. I accept that this release covers and includes, but is not limited to, all unknown and unforeseen claims, injuries, damages and losses, and any consequences thereof. I knowingly and voluntarily give up valuable legal rights, including the right to sue. This release shall extend to and include Unbound Earth School, LLC and the event organizer, partners, managers, officers, agents, contractors and volunteers including medical and paramedical personnel appointed for the activities, the owners, licensees, and occupiers of land on which the activities or any part of it are conducted or which is involved directly or indirectly with the activities in any manner whatsoever. This release and indemnity continues forever and binds my heirs, executors, personal representative and assigns.Participation in the activities at Unbound Earth School, LLC carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I acknowledge the risks involved in the activities conducted at Unbound Earth School, LLC. These risks or dangers may be caused by other participants, or by accidents, or by forces of nature or other causes. I further understand and agree that there may be risks and dangers not known or reasonably foreseeable at this time. I have read this waiver of liability, assumption of risk and indemnity agreement, fully understand its terms and I understand that by signing this document I hereby release Unbound Earth School, LLC from any and all liability associated with the program my child is attending. I understand that I give up substantial rights by signing it, and sign it voluntarily.Signature of responsible person:*

Clear
Name Of Person Signing Waiver*

First NameLast Name
Date*

MonthDayYear
Date
When you select, "submit" you will be redirected to our Paypal to submit your payment of $40. Please submit payment to complete registration, otherwise your space will not be reserved. If you need financial assistance, please email us. Thank you!
Should be Empty:

Registration Form For Spring Classes

Select Class

Emergency Contact Information

Waiver

When you select, "submit" you will be redirected to our Paypal to submit your payment of $40. Please submit payment to complete registration, otherwise your space will not be reserved. If you need financial assistance, please email us. Thank you!