Clone of Earth Tenders Registration 2025

Contact Information
Parent/Guardian

First NameLast Name
Cell Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Wellness & Waivers
Please list the names (and relationship to child) of anyone other than parent noted above who have permission to pick up your child.
Does the student have any allergies, or medical conditions? If yes, please describe. Medications to be administered during camp?
Please note important information we should know about this child. For example, my child needs extra potty reminders, this is their first time in a group setting, etc.
You have permission to use my child's photo for publicity purposes.

YesNoYes, but no social media
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Earth Tenders during the selected camp/s. In exchange for the acceptance of said child’s candidacy by Earth Tenders, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Earth Tenders and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of participating in selected camp sessions.

In case of injury to said child, I hereby waive all claims against Earth Tenders . including all staff and affiliates, all participants, and owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities.
Medical Release and Authorization

As Parent and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is also granted to the staff at Earth Tenders to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY BINDING.
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Date
Camps are from 9am-2pm and $375 per camp week. You must pay the full tuition for all camps at time of registration, and payments are non-refundable (unless otherwise agreed upon). If you are in need of tuition assistance or a payment plan please reach out.

Please note:

The camp quantity equals the total number of weeks your child/ren are enrolled.

For example, if you enroll 2 children for 2 weeks each, you should select a quantity of 4.
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Earthtenders summer camp (1 week of camp)
$375.00 Quantity

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Wellness & Waivers