Garden Detectives Camp Registration

2018 Garden Detectives Camp Registration Form

Please use one form for each camper registering.
Garden Detective Camp is for children ages 5-7. The camp is from June 11th through June 15th and costs $75. Drop-off is from 8:30AM-9AM each morning and pick-up is from 2PM-2:30PM each afternoon. Questions? Contact Kelli Meeker, MFBG Youth and Outreach Coordinator at kmeeker@moorefarmsbg.org or by phone at (843) 210-7582.
Camper Information:
Child's Name: *

First Name Last Name
Gender: *

Male Female
Child's Date of Birth *
DD/MM/YYYY
Age: *
Phone Number *

- Area Code Phone Number

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Emergency Contact:
Name of Parent(s)/Guardians *
E-mail *
Daytime Phone for Parent(s)/Guardian:
Mother Primary: *

- Area Code Phone Number
Mother Secondary:

- Area Code Phone Number
Father Primary: *

- Area Code Phone Number
Father Secondary:

- Area Code Phone Number
Secondary Contact: *

First Name Last Name
Phone Number *

- Area Code Phone Number
Relationship to Camper *
Drop-off/Pick-up Information:
Child must checkout with Kelli Meeker or camp educator before leaving. Please list all adults who are allowed to drop-off or pick-up this camper. PHOTO ID WILL BE REQUIRED

Drop-off: 8:30 am to 9:00 am Pick-up: 2:00 pm to 2:30 pm
Name *

First Name Last Name
Relationship to Camper: *
Phone Number *

- Area Code Phone Number
Name

First Name Last Name
Relationship to Camper:
Phone Number

- Area Code Phone Number
Name

First Name Last Name
Relationship to Camper:
Phone Number

- Area Code Phone Number
Are there any custody issues we need to be aware of? *

Yes No
If yes, please explain:
Cancellation and Refund Policy:
Registration fees are 100% refundable when Moore Farms Botanical Garden (MFBG) cancels an activity. Participants wishing to withdraw from a camp that has not been cancelled by MFBG must provide a written request by June 4, 2018. If the withdrawal request is received by June 4, 2018, a 50% refund will be provided. No fees will be refunded if registration is cancelled after Friday, June 8th, 2018.

I give consent for my child to participate in activities of the 2018 Garden Detectives Camp.
Parent/Guardian Signature (please use mouse to write inside box) *

Clear
Type Name *
Date *

- Month - Day Year
Date

Moore Farms Botanical Garden

Release and Waiver of Liability (Camp participation of minor child) PLEASE READ CAREFULLY. THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR RIGHTS!
I, {nameOf}, the parent or legal guardian of {childsName}, give permission for my child (“Child” or “Participant”) to participate in the Garden Detectives Camp 2018 (“Activities”) and give this Release and Waiver of Liability (the “Release”) in favor of Moore Farms Botanical Garden Foundation and Moore Farms Botanical Garden, LLC, and their respective trustees, officers, employees, volunteers, contractors, and agents (collectively, “Sponsor”). I agree that this Release shall apply to each time my Child has or will be participating in the Activities, regardless of the date that this Release is signed below. I understand that the Activities will take place at Moore Farms Botanical Garden in Lake City, South Carolina.

In consideration of participation, I hereby freely, voluntarily, and without duress execute this Release under the following terms:

1. Waiver and Release. I hereby release and forever discharge and hold harmless Sponsor and their respective successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or equity, which arise or may hereafter arise from participation in Activities. I understand and acknowledge that this Release discharges Sponsor from any liability or claim that I or my Child may have against Sponsor with respect to any bodily injury, personal injury, illness, death, or property damage that may result from participating in Activities with Sponsor, whether caused by the negligence of Sponsor or others. I also understand that, except as delineated, Sponsor does not assume any responsibility or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance, in the event of injury, illness, death or property damage. I also intend this Release and Waiver to be binding on my heirs.

2. Insurance. I understand that Sponsor does not carry or maintain health, medical, or disability insurance coverage for any Participant. Each Participant is expected and encouraged to arrive with medical or health insurance and coverage in effect.

3. Medical Treatment. I hereby release and forever discharge Sponsor from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during Participant’s time with Sponsor.

4. ASSUMPTION OF RISK. I understand that the Activities include undertakings that may be hazardous to my Child, including, but not limited to, walking, standing for extended periods of time in confined spaces, fishing, running, crafts, consuming food, nature hikes, outdoor games, activities associated with nature and outdoors and other participation-related Activities. I recognize that my Child’s participation, in some situations, involves inherently dangerous activities. I hereby acknowledge that I have been fully informed of the risks and dangers inherent in the Activities, and expressly and specifically assume the risk of injury, illness, death, or property damage resulting from the Activities.

5. Photographic Release. I hereby grant and convey unto Sponsor all right, title, and interest in any and all photographic images and video or audio recordings made by Sponsor during Participant’s Activities, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

6. Other. I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of South Carolina, and that this Release shall be governed by and interpreted in accordance with the laws of the State of South Carolina. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release, which shall continue to be enforceable.

TO EXPRESS YOUR UNDERSTANDING OF THIS RELEASE, SIGN HERE:
Signature (please use mouse to write inside box) *

Clear
Type Name *
Relationship to Child *
Date *

- Month - Day Year
Date
Should be Empty:

2018 Garden Detectives Camp Registration Form

Camper Personal Health and Medical History

Moore Farms Botanical Garden