CAMP TAPAWINGO
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Vespers by Glen Scrimshaw
Junior 1 Camp (ages 10-11) (boys are full)
SKU:
CA$350.00
CA$350.00
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Registration Information
Camper Information
*
First
Last
[object Object]
*
Indicates required field
Gender
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Male
Female
Other
Birthday
*
Age
*
Cabin Mate Request (maximum 2)
*
Address
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Line 1
Line 2
City
State
Zip Code
Country
Phone Number
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Secondary Phone Number
*
Email
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Name of Physician
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Hospitalization Number
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Date of last tetanus shot
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Chronic Conditions (check all that apply):
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Allergies
Illness
Asthma
Diabetic
Bedwetting
Hay Fever
Epilepsy
Nightmares
Heart Ailment
Sleepwalking
ADD/ADHD
Other Conditions:
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Details of Condition(s)
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Please explain further
Camp Tapawingo staffing does not enable us to provide for all special circumstances. Therefore we reserve the right to refuse campers whose medical or supervisory care is beyond our ability to meet. All campers and parents must report to the medical person at camp to ensure we have all current information about the camper.
Choose One
*
Yes
No
I give my permission for any photographs or videos of camp activities which may include all names listed on this registration form to be used in camp promotional materials, brochures and websites.
Waiver and Release of Liability and Indemnity Agreement
In CONSIDERATION of the camper's being permitted to participate in the camp operated by Camp Tapawingo Committee (here in 'The camp')
1. I,
( Name of Parent/Guardian )
, for myself, the campers,
( Name of camper above )
, my spouse, the camper's heirs, personal representatives, and assigns, hereby release, discharge and agree to hold harmless and indemnify the camp, its officers, directors, managers, counsellors and any and all of its personnel of any from all liability, loss, damage, or injury to person or property in any way resulting from or arising in connection with or related to the camper's participation at the camp. It is fully understood that this means that the camp cannot be sued if any personal injury is suffered during the camp or if any property is damaged, lost, or stolen while the camper is at camp.
2. FURTHERMORE, I, on behalf of the camper, as well as for myself hereby undertake to indemnify the camp against any and all liability, loss or damage from which the camp may be found liable as a result of claims, demands or judgments against the camp arising from any act or failure to act on the part of the camper during the course of the camp, for which act or failure to act either I or the camper may be found liable at law. It is fully understood that this means that if a camper causes injury to another person or damages another persons property while at the camp, and the camp has to pay an amount to that person, the camp can recover the paid from me.
I HEARBY DECLARE THAT I HAVE READ THIS RELEASE AND INDEMNITY AGREEMENT AND ACCEPT THE SAME IN FULL ON BEHALF OF MYSELF, MY SPOUSE, THE CAMPER, THE CAMPER'S HEIRS, PERSONAL REPRESENTATIVES AND ASSIGNS.
Registration will not be fully completed until payment has been received.
Choose One
*
Yes
No
I agree with the terms and conditions presented in the above waiver.
Parent/Guardian Full Name:
*
Submit
Home
About Tapawingo
What to Bring
Employment
Contact Information
Directions
Photo Gallery/slideshow
Camper Sponsorship
History
Online Store
Vespers by Glen Scrimshaw