Nashville Shores Junior Lifeguard Program

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2026 Junior Lifeguard Medical Release Form
Camper Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Campers Age*
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contacts*

First NameLast Name
Emergency Contact Phone Number*
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Emergency Contacts

First NameLast Name
Emergency Contact Phone Number
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Emergency Contacts

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Are there any known medical conditions? If so, please list below.*
Are there any special precautions to be observed during camp?*
Medication needed during the camp will need to be provided to Nashville Shores EMT Staff in the correct dosage amounts needed for the week. These medications will be kept in our First Aid Building and will be self-administered by your participant according to the times and dosage listed below. Medications must be properly labeled with the participant's name and the information listed below.
Medication Type: Dosage: Time:
Medication Type: Dosage: Time:
Medication Type: Dosage: Time:
Additional Medication Notes:
YesNo
All camp participants can pack their lunches for the camp week in which they are participating. No glass containers are allowed, and their lunch should be packed in an insulated container with some type of ice pack. Two snacks are provided for every participant, each day of camp.

Food and Beverage: The Park has a wide assortment of foods and beverages available, including bottled water.

Allergies: We are not the food manufacturers/ suppliers (we get all food and beverage product from third parties), and as such, we regret to inform you the THE PARK CANNOT, AND DOES NOT, MAKE ANY REPRESENTATIONS OR GUARUNTIES WHATSOEVER REGARDING THE ALLERGY-FREE CONTENTS OF ANY FOODS OR BEVERAGES. At a minimum, guests with allergy concerns should avoid any foods or beverages unless they are packaged, and you are 100% confident in the manufacturer/ supplier whcih has provided the park with such food or beverage. Foods that are in any way unpackaged, prepared, or handled by the park (as opposed to packaged goods, provided to you in a sealed package), have a higher risk of contamination with other products containing allergens, so in the interests of your safety, we strongly urge you to avoid all such unpackaged products provided by the park.
Please list all allergies that apply?
YesNo
Nashville Shores EMT staff is willing to assist with the administration of the Epi-Pen under the following conditions:

The Epi-Pen must be provided to Nashville Shores EMT staff.
Nashville Shores EMT staff will not administer unless it is a life-threatening situation, and the participant is unable to self-administer the injection.
You acknowledge that there are certain side effects and risks associated with administration of the Epi-Pen. You agree to release from any and all liability of cause of action Nashville Shores and its employees from any and every claim, demand, action or right of action, or whatsoever kind of nature, either law or in equity arising from or by reason of any bodily injury or personal injuries known or unknown or death resulting on account of the Epi-Pen injection administered to the participant while participating in the program.
Medical Release

In case of any medical emergency, I hereby give my permission to Nashville Shores to administer emergency care and to secure proper treatment, transportation and/ or Emergency Room treatment for my child/ camp participant while participating in Nashville Shores Junior Lifeguard Camp
Medical Release Signature of Parent/ Guardian*

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Parent/ Guardian Name*

First NameLast Name
Camper Name*

First NameLast Name
Camper Date of Birth*

MonthDayYear
Date

2026 Junior Lifeguard Camp Waiver for Participation
I {parentguardianName}* do hereby agree to allow {campersName}* to participate in Junior Lifeguard Camp. I understand there is risk inherent in the activities at the park premises and I, for myself and/ or dependents, assert responsibilty and assume all such risks inherent in the participation of activities, the use of the facilities, the conduct of other parties, and the amenities available on the park premises. I am aware of the possibility of accidental or other physical injury which may befall my child during their use of the facility, equipment and participation in Junior Lifeguard Camp conducted by Nashville Shores. I further agree to indemnify, hold harmless the park and its affiliated companies, their agents, employees, and volunteers from and to waive all claims, causes of action, demands, and liabilities for any personal injury, property damage, which may be suffered by the aforementioned individual arising out of or in any way connected with their participation in this activity. I understand that my child must abide by all park rules and policies, as well as the instructions of Nashville Shores Staff. Nashville Shores is not liable for any lost or stolen objects. I grant Nashville Shores the right to film/ videotape/ photograph the participant on park property for any purpose without payment or consideration thereof.

Swimming Ability:
To participate and enjoy camp to the fullest, participants should be able to keep their heads above water, treading and swimming in deep water without assistance, and swimming under water. Regardless of their swimming ability, participants will be required to wear a lifejacket when their instructor deems it necessary.
Parent/ Guardian Signature*

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Parent/ Guardian Name*

First NameLast Name
Additional Contact Information

Please add the names of people other than the parent or guardian who are listed above allowed to pick-up the participant.

ID's are required from any person picking up your camper.

In the future, any additional pick-up contacts must be added in person by the parent or guardian, no phone or email requests will be authorized.
Name

First NameLast Name
Relationship to Camper
Phone Number
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Name

First NameLast Name
Relationship to Camper
Phone Number
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Name

First NameLast Name
Relationship to Camper
Phone Number
Please enter a valid phone number.

My Products

Full-Day Camp Deposit

Remaining Balance due 1 week prior to start date of camp. Invoice will be sent to email that was used to register. Any discounts will be applied to invoice after confirmation.

$200.00 Quantity

Half-Day Camp Deposit

Remaining Balance due 1 week prior to start date of camp. Invoice will be sent to email that was used to register. Any discounts will be applied to invoice after confirmation.

$100.00 Quantity

Camper Meal Deal

Save time and money with our discounted Meal Deal and Souvenir Cup package! With a Camp Meal Deal your camper will enjoy one combo meal with a regular sized drink or souvenir cup refill each day of camp and a discounted Souvenir Cup to use all season for just $52.99 + tax.

$58.15 Quantity

Total

$0.00

Credit Card

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Street Address

Street Address Line 2

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State / Province

Postal / Zip Code

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Nashville Shores Junior Lifeguard Program

2026 Junior Lifeguard Camp Registration

2026 Junior Lifeguard Medical Release Form

2026 Junior Lifeguard Camp Waiver for Participation