HOWL Health and Waiver Form

First Name

Last Name

Date of Birth

Date

Gender

Parent/Guardian Name(s)

First NameLast Name

Mailing Address

Primary Phone

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

Email

example@example.com

Seconday Email

example@example.com

Emergency Contact First Name

Emergency Contact Last Name

Relationship to Participant

Emergency Contact Phone

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

Alternate Emergency Contact First Name

Alternate Emergency Contact Last Name

Alternate Relationship

Alternate Phone Number

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

Authorized Pick-Up Individuals

Does your child have any allergies?

Has your child been stung by a bee?

Medical conditions, allergies, dietary restrictions, or medications staff should be aware of to better care for your child. Please inform Sarah if your child carries an epi-pen.

Additional information you would like HOWL instructors to know about your child.

Do you give permission for sunscreen and bug spray to be applied to your child? Please provide non-aerosol bug spray and sun screen if your child uses them.

Please check your permission level for use of your child's photograph.

Acknowledgment of Risk

I understand that participation in programs, camps, hikes, outdoor recreation, environmental education activities, crafts, field activities, transportation, and related events offered through HOWL Nature Company involves inherent risks.

These risks include, but are not limited to:

- Falls or physical injury
- Exposure to weather and environmental conditions
- Uneven or unpredictable terrain
- Insect bites and tick exposure
- Contact with plants, including poison ivy
- Wildlife encounters
- Water-adjacent activities, such as stream exploration or shoreline observation
- Transportation-related risks
- Loss of or damage to personal property
- Other hazards commonly associated with outdoor educational activities

Voluntary Participation and Assumption of Risk
I acknowledge that my child's participation in the above activities is voluntary. On behalf of myself and my child, I knowingly and voluntarily assume all reasonable risks associated with participation described above.

Release, Waiver, and Hold Harmless
In consideration of my child's participation, I, on behalf of myself, my child, our heirs, and personal representatives, release, waive, discharge, and covenant not to sue the HOWL Nature Company, together with their respective officers, employees, volunteers, partners, affiliates, and program instructors (collectively, the "Released Parties"), from any and all claims, liabilities, damages, losses, costs, or expenses of any kind arising out of or in connection with my child's participation in the above activities, whether arising from the negligence of the Released Parties or otherwise, except for claims arising from the gross negligence or willful misconduct of the Released Parties.

Please type your name and enter the date to show you agree to the above information.

Date

Signature

Date

HOWL Health and Waiver Form

Participant Information

Emergency Contact & Pickup

Medical, Allergy & Additional Information

Permissions

Waivers of Risk and Hold Harmless