Summer Camp Please fill out the form below with as much detail as possible Make a Donation Steward An Acre Primary Legal GuardianFirst NameLast NameE-mail AddressStreet AddressCityProvincePostal CodeHome PhoneWork PhoneCell PhoneSecondary Legal GuardianFirst NameLast NameE-mail AddressStreet AddressCityProvincePostal CodeHome PhoneWork PhoneCell PhoneChild InformationChild First NameChild Last NameGenderAny Allergies?YesNoAllergy Description and Allergic ReactionsAny Medical Conditions?YesNoExplain any Medical Conditions, Medications, Dosages and FrequenciesWho should be considered the Primary Emergency Contact?Primary Legal GuardianSecondary Legal GuardianOtherOther Emergency ContactFirst NameLast NameE-mail AddressStreet AddressCityProvincePostal CodeHome PhoneWork PhoneCell PhonePassword To Release Custody of the ChildIf Child is attending with a sibling or friend, who would you like them paired with? (Optional)Is there anything else you would like to tell us about your child?Does your child require additional aide support in school?If Yes, please note you will be required to provide additional aide support for your child at GRPF Summer CampsYesNoWhere did you hear about our Summer Camps?Select all that applySocial MediaNewsletterQualico CommunitiesPreviously AttendedSchool RecommendationFamily or Friend ReferralSuburban Journals Community Association MagazineOtherConsent to GRPF Waiver & Liability * The Participant has met all of the prerequisites required for participation in the Activity. The Participant will abide by the rules and regulations imposed on the participants in the Activity. There are risks and hazards inherent in the very nature of the Activity and that as a result of these risks and hazards, the Participant, may suffer personal injury, even death, as well as property loss. I am aware and understand the risks and hazards associated with the Activity and which may be present in the Activity and that the Participant is assuming the risks and hazards at his or her own risk. I waive any claim the Participant or I may have against the Glenbow Ranch Park Foundation (GRPF) and any and all instructors, coaches and organizers of the Activity and their respective heirs, representatives, successors and assigns from all claims, demands, costs, expenses, actions and causes of action arising from the Participant's involvement in the Activity and agree to indemnify and hold harmless the Glenbow Ranch Park Foundation from any claim, including any claim for medical services arising from the Participant's involvement in the Activity. Glenbow Ranch Park Foundation may secure such medical advice and services as it, in its sole discretion, may deem necessary for the Participant's health and safety and I shall be financially responsible for such advice and services. I understand that the Glenbow Ranch Park Foundation does not provide accidental death, disability, dismemberment or medical expense insurance on behalf of the participants the Activity and therefore agree to assume responsibility for such insurance coverage for the Participant. I agree that in the event that any provision of this Form is held to be invalid and unenforceable by any court of competent jurisdiction, the invalidity or unenforceability of such provision will not affect the remaining provisions of this Form, which shall continue to be enforceable. This CONSENT, RELEASE OF LIABILITY, WAIVER OF CLAIM, ASSUMPTION OF RISK and INDEMNITY is binding on the Participant and I, and our heirs, executors, administrators, personal representatives and assigns. WE HEREBY ACKNOWLEDGE READING, UNDERSTANDING AND AGREEING WITH THE FOREGOINGImage Release Consent *During GRPF programs, film and photos may be taken for media or marketing purposes. Please check yes to the image release below if you are willing to have yourself or your child participate in film or photo opportunities. I/my child has permission to participate in media coverage and photographs of programs at Glenbow Ranch Provincial Park. I hereby grant the Glenbow Ranch Park Foundation the right and permission to publish moving composite reproductions for the purpose of, without limitation, television, publications, and any trade or advertising purposes. Accordingly, I release and discharge the Glenbow Ranch Park Foundation from any liability by virtue of blurring, distortion, alteration, optical illusion or use in composite form that may occur or be produced in the taking of said picture(s) or any processing through completion of the finished product. YesNoSubmit Camp Registration
