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REGISTRATION

Please take a moment to fill out the form below.  Our team will get back to you with payment details. 

Please list all the people allowed to sign your child in and out of camp.*

Waiver & Release Consideration: I acknowledge the personal benefits accruing to my child by reason of participation in the above described event and am aware of the activities which my child will be involved through said participation. Release / Indemnification: I hereby, in consideration of such benefits and other good and valuable consideration received, consent to the above listed participation and release absolutely, forever discharge, hold harmless and covenant not to sue Community Roots Inc., and camp location, its directors, employees, agents, volunteers, and affiliates from any and all present or future liability, claims, demands, actions or rights of action, whether asserted by me or a third party arising out of my child's participation in the event activities. I agree to indemnify and hold harmless Community Roots Inc. and camp location for any such Claims brought by me or a third party from any costs associated with defending or litigating such claims, including but not limited to attorney fees, costs and legal expenses. Assumption of Risk: I am aware of the risks associated with participation in the above event and do hereby voluntarily assume full responsibility for any risk of loss, property damage or personal injury, including death, that may result from participation in event activities. Medical Emergency: In the event of an injury or medical emergency, I understand that the teacher, not Community Roots Inc. and camp location, will be responsible for the medical care of all attendees. It will be the teacher's responsibility to assess medical needs, obtain and consent to appropriate medical care, transport persons in need of medical care and contact parents or guardians or minors. I release Community Roots Inc. and camp location from any and all liability related to medical treatment. In addition, I assume the risk and financial responsibility for any injury resulting from the attendee's participation in all camp events. Technology Camp Authorization Addendum: I acknowledge that during my child's participation in Summer Camp F.O.C.U.S. that certain risks do exist. These include, but are not limited to, the hazards of outdoor and indoor physical activities, and risks associated with access to the Internet (viruses/malware). In consideration of this acknowledgement, I voluntarily have and do hereby, assume all risk associated with my child's participation in these programs. Media Consent: I give my consent and permission for the taking of photographs and/or video of my child during the described event and waive and/or assign any and all rights (including copyright) in such media to Learn.Create.Build. Learn.Create.Build, as the sole owner of such media, shall have exclusive rights to control and determine the use, display, performance, reproduction and dissemination of any such photographs and/or videos.

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