Spring Break Camp Registration & Waiver

Spring Break Camp Registration & Waiver

5 Day Program: March 17th - 21st 9:30am-2:30pm | $150 Camp Fee
Child's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
MaleFemale
School Name (if applicable)*
Allergies or anything else we should know?*
If your child is taking any medications or has any health problems or limitations (eg. hearing, speech, vision, physical or emotional difficulties, etc.) that might affect their participating in the program, please provide more information below.

Parent/Guardian Name*

First NameLast Name
Parent Mobile Phone*
Please enter a valid phone number.
Parent email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact 1
Emergency Contact Name*

First NameLast Name
Mobile Phone*
Please enter a valid phone number.
Email
example@example.com
Relationship to Participant*
Emergency Contact 2
Emergency Contact Name*

First NameLast Name
Mobile Phone*
Please enter a valid phone number.
Email
example@example.com
Relationship to Participant*

PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK
The safety of Sequoia Park Forest School students is our top priority. During nature school, the educator’s role is to make sure the group is physically safe and comfortable. We also assess the overall safety of the site and the risk management required for specific activities.

In consideration of the services of Sequoia Park Forest School, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf, I (Parent/Guardian of Student) hereby agree to release, indemnify, and discharge Sequoia Park Forest School, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows:

1. ACKNOWLEDGMENT AND ASSUMPTION OF RISK
I acknowledge and agree that I am aware that there are many known and unknown dangers and risks associated with participation in the outdoor nature program including, but not limited to, the risk of minor injuries such as cuts, bruises, and scrapes, insect bites, insect stings, as well as the risk of serious injury or death. I acknowledge and agree that I understand the aforesaid dangers and risks associated with the outdoor nature program and notwithstanding such dangers and risks agrees to provide my permission for the Student to participate in the outdoor nature program. I expressly agree and promise to accept and assume all of the risks existing in this activity. My and my children’s participation in this activity is purely voluntary, and we elect to participate in spite of the risks.

2. RELEASE AND WAIVER OF CLAIMS
I hereby voluntarily release, forever discharge, and agree to indemnify and hold Sequoia Park Forest School from any and all claims, demands, or causes of action, which are in any way connected with my and my children’s participation in this activity or my use of Sequoia Park Forest School's equipment or facilities or facilities which they use or rent, including any such claims which allege negligent acts or omissions of Sequoia Park Forest School or any persons acting on their behalf.

3. INDEMNITY
Should Sequoia Park Forest School or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. I certify that I have adequate insurance to cover any injury or damage I or my children may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I or my children may have

4. MEDICAL CONDITIONS
If you or the Student have any personal medical conditions or problems that Sequoia Park Forest School should be aware of, it is your responsibility to acquaint us with the existing condition at the registration for the program. All information gathered will be held in confidence and used only to render proper assistance to you should the need arise.

5. FIRST AID
I hereby authorize Sequoia Park Forest School, in the event of a perceived emergency, to administer first aid to the child and transport or arrange emergency transport to a medical facility for medical treatment.
Yes
Payment Schedule Policy

In order for the child to participate in the program the full fee has to be paid before the start of the program. Payments can be made via venmo to the Program Director @SequoiaPark or Cashapp $SequoiaPark

Cancellation and Refund Policy

If a child is unable to attend the program, then a 7 days notice is required to receive up to a 50% refund. No refund will be given with less than 48 hours notice. If a day’s program must be canceled due to educator illness, a full refund for the day will be issued.
Yes
I agree
Signature*
Date*

MonthDayYear
Date
Should be Empty:

Spring Break Camp Registration & Waiver

Emergency Contact 1

Emergency Contact 2

PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK