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This is the Waterboyz Camp Waiver

TODAY'S DATE: September 28, 2021

WAIVER: In consideration of my application to enroll in Waterboyz surf, skate, or skim camp, I hereby release Waterboyz-WBZ, inc. and any other person/ sponsor officially associated with the surf, skate, or skim camp from all liability and/or lawsuit for any and all injuries and/or damages whatsoever arising from my participation or my presence at the surf, skate, or skim camp.

PHOTO CONSENT: I hereby agree that Waterboyz my use film or photographic records of this surf, skate, or skim camp for its promotional and/or commercial purposes without compensation to me, and I consent to the use of my name and likeness for such use in any media now known or not known.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Parent or Guardian's Email Address

Email*

Confirm Email*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
T-Shirt size:*

Medical Information:


Allergies:

Medical Problems:

Medication:

Notes:
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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