Kids Camp Registration

Kids Camp Registration Form

Fields marked with a * are required.

Camper Information

Family Information

Emergency Contact Information

List persons other than parents to contact in case of emergency when parents can not be reached.

Medical Information

Medical History: Please list any and all special instructions concerning this camper- (i.e. allergies to drugs, foods, bees, special diets, or any activity you wish your child not to participate in.)

Can Camper Swim?

Release Form

ALL PARENTS: I realize that young people at camp can become injured. I hereby assume the risk of all injuries to my child and hereby release and discharge Waterfall Club , its agents and employees, from any and all liability, which may result from injury to my child. Insurance protection is my responsibility. I give my permission for my child to participate in all camp activities on and off the camp property either by walking or riding in a camp vehicle. In case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the physician selected by Waterfall Club to hospitalize and secure proper treatment (including surgery) for my child. By submitting this form I attest that I am the parent or guardian and over the age of 18. By submitting this form I agree to indemnify Waterfall Club for all liability of injury to my child and I understand an electronic record has been secured by Waterfall Club as proof of this indemnification. Electronic Signature below

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