Summer Camp Waiver Form
Please read and complete the waiver to participate in the summer camp.
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Waiver and Release of Liability: By signing below, I acknowledge that participation in the summer camp involves inherent risks. I agree to release and hold harmless the camp organizers from any liability for injuries or damages that may occur. I confirm that I have read and understood this waiver.
Signature of Parent/Guardian
*
Submit Waiver
Submit Waiver
Should be Empty: