Family Registration Form for Tidewater Nature Club, LLC

Parent Full Name

First NameLast Name

Parent Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Parent Email Address

example@example.com

Student Information

Younger Sibling Information (ages 4 and under)

Which session(s) are you registering for?

Session Fee

This covers a 4-week instructional session with lessons, hands-on activities, experiments, crafts and weekly materials. How many sessions would you like to register for? (Adjust quantity. For example, 2 students x 4 sessions = 8 entered in quantity) Don't forget to click the checkbox!

$85.00 Quantity

Student Registration Fee

This is an annual, one-time registration fee that covers the students' materials and supplies to get started with the program. Adjust quantity to match number of students age 5+. (Siblings 4 and under are welcome to attend for free.) Don't forget to click to checkbox if paying this one-time fee per student.

$100.00 Quantity

Total

How do you plan to pay? Spots are not held without payment.

Liability Waiver Agreement

Assumption of Risk & Liability Release

I, the undersigned parent/legal guardian, understand that participation in activities hosted by Tidewater Nature Group, LLC may involve inherent risks, including but not limited to hiking, outdoor exploration, water activities, nature play, uneven terrain, exposure to insects, wildlife, weather conditions, and other outdoor-related risks. I voluntarily allow my child(ren) to participate in all activities associated with Tidewater Nature Group, LLC and acknowledge that I assume all risks associated with participation. In consideration for being allowed to participate, I hereby release, waive, discharge, and hold harmless Tidewater Nature Group, LLC, its owners, leaders, volunteers, assistants, and representatives from any and all claims, liabilities, demands, damages, costs, expenses, or causes of action arising out of or related to any injury, illness, loss, or damage that may occur during participation in activities, except in cases of gross negligence or willful misconduct.

Medical Authorization

In the event of an emergency, I authorize Tidewater Nature Group, LLC leaders or representatives to obtain emergency medical treatment for my child(ren) if I cannot be reached immediately. I understand that I am financially responsible for any medical treatment provided.

Parent Responsibility

I understand that Tidewater Nature Group, LLC is intended to be a family-oriented community group and not a drop-off childcare program unless specifically stated otherwise for a particular event. I agree that I am responsible for supervising my child(ren), including behavior, medical needs, bathroom needs, and safety, during activities and events unless otherwise communicated.

Photo & Media Release: I grant permission for Tidewater Nature Group, LLC to photograph or video my child(ren) during activities and to use those images for group communication, social media, or promotional materials. (We typically post weekly event photos in a private Facebook group.)

Signature