Clone of CBC Winter Warm Up Registration 2

1
Adult 1* This field is required.
First Name
Last Name
2
Email* This field is required.We will email you detailed instructions for the event as the date approaches.
example@example.com
3
Phone Number* This field is required.
Area Code
Phone Number
4
Adult 2
First Name
Last Name
5
Please let us know the number of children in your group and their ages below.Children not required but always welcome!
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Small
Ok
Ok
6
Please let us know the names of any other adults in your group.No worries if an extra person or two joins on the day of the event—we just want to make sure we have plenty of food for everyone!
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Large
Normal
Small
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Ok
7
Is this your first time visiting Camp Beech Cliff?* This field is required.
YESNO
8
How did you hear about the Winter Warm Up?
Please Select
Please Select
Social Media
Email
Community Bulletin
CBC Newsletter
CBC Website
Family/Friend
Other
9
Informed Consent & Acknowledgement of Risk* This field is required.Adventure Programs often involve physically and emotionally demanding activities in an outdoor and sometimes indoor setting. It is required that you read the following very carefully, make sure you understand it, and sign it before you begin participating in the program. Please contact us if you have any questions. Thank You.I am fully aware that the programs that I am choosing to participate in may include rigorous physical activities. I am also aware that there are risks of serious physical injury or harm from participating in these programs. I voluntarily elect to participate in the program and to assume all risks of injury or harm that could result from participation. I understand that the level of participation in the programs is at all times completely voluntary and up to the individual’s choice. I agree that I will not make a claim or bring suit against Camp Beech Cliff, or Camp Beech Cliff MDI, LLC, it’s employees, agents, officers, directors or consultants, regarding any personal injury or property damage I or my child may incur while participating in the program or using the facilities, and hereby release the aforementioned from any responsibility or liability for any injury or harm. I further agree to defend, hold harmless and indemnify the aforementioned from any and all such claims. I have read and understand this release of liability. I voluntarily sign it. I agree that the substantive laws of Maine govern this document and other aspects of my relationship with Camp Beech Cliff and Camp Beech Cliff MDI, and that any mediation, suit, or other proceeding must be filed or entered into only in Maine.I hereby give permission for the leaders of the stated program and organization to administer medical assistance equivalent with their standard of care and/or to seek appropriate medical assistance for the participant listed. I affirm that my health is good, and that I am not under a physician’s care for any undisclosed condition that bears upon my fitness to participate in adventure programs or outdoor education programs here at the outdoor center at Camp Beech Cliff. IF UNDER 18, MUST BE SIGNED BY PARENT/GUARDIAN.
Type your name here to sign confirm consent
10
Photo ConsentWe’ll be taking a few photos during the event for our newsletter and social media pages. Please provide your name below as a signature release to grant permission for the use of your group's photos.
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