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Kayak Kids Kamp Registration
Kayak Kids Kamp Registration
I, __________________________, hereby give my child, _______________________, permission to attend and participate in Kayak Kids Kamp, hosted by Grande Tours, INC. I understand that it is my or my designee’s responsibility to drop off and pick up my child at the specified time. I also understand that, with any water sport, there are certain risks associated with kayaking. I hereby waive my right to file suit against Grande Tours, INC or any employee of Grande Tours, INC for any bodily injury or harm that my child may encounter during this camp.
I have been assured that my child will be outfitted with the proper size of Personal Flotation Device (PFD) and has been given sufficient and accurate instructions so that he/she may participate safely.
I have informed the camp counselors and staff of Grande Tours, INC of any physical limitation, illness, potential harmful physical ailment, or medication that my child may carry.
I recognize my right to ask questions, actively participate in parent events, and remove my child from the program without receiving a refund of any kind. I understand that I will be charged $170.00 + tax for a total of $181.90 for this camp.
I have read the following dates below over which two camp sessions will be run:
I HAVE READ THE ABOVE WAIVER AND RELEASE. I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS. I SIGN IT VOLUNTARILY. Parent Signature: _______________________________ Date: ___________ Parent Printed Name: ________________________________________ Camper’s Information Name: _____________________________________ Age: ________ D.O.B.: _____________ Circle Y/N: Camper can swim………………………………………………………..Y / N Camper has allergies…………………………………………………….Y / N If YES, please list: ____________________________________ _____________________________________ _____________________________________ Camper has kayaked prior to camp……………………………………...Y / N Camper has any psychological disorders………………………………..Y / N If Yes, please define: ________________________________ _____________________________________ _____________________________________ Camper has developmental or learning disabilities.............................Y / N If Yes, please define: ________________________________ _____________________________________ _____________________________________ Camper has any medications……………………………………………..Y / N If Yes, please list: ____________________________________ _____________________________________ _____________________________________ Emergency Contact Name: _________________________ Address: _________________________ _________________________ _________________________ Phone: _________________________ (home) _________________________ (cell)
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