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Shenaniganz Summer Camp Waiver

In the event of injury, illness or emergency, I hereby authorize SHENANIGANZ and or their agents and employees (“SHENANIGANZ”) to secure medical care and treatment for my child(ren), including, but not limited to an X-ray, examination, anesthetic, medical, dental or surgical diagnosis or treatment and/or hospital care as deemed reasonably necessary for the safety and welfare of my child(ren). I agree to assume financial responsibility for any resulting medical charges.

I fully understand that my child(ren) are required to follow all rules and requirements governing conduct during the camp. Hereby acknowledge that if my child(ren) is/are determined to be in violation of these behavior standards, I will be notified via phone and will be required to come pick up my child(ren) from SHENANIGANZ immediately.

I, the undersigned, hereby agree to release, hold harmless, indemnify and waive all claims against SHENANIGANZ, its related companies and/or its agents and employees for any claims, lawsuit and/or demands in any way related to or arising from my child(ren)’s presence on the premises.

March 28, 2024

 

First Campers Name

First Name*

Middle Name

Last Name*
First Campers Date of Birth*
First Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
First Campers Signature*
Second Campers Name

First Name*

Middle Name

Last Name*
Second Campers Date of Birth*
Second Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Third Campers Name

First Name*

Middle Name

Last Name*
Third Campers Date of Birth*
Third Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Fourth Campers Name

First Name*

Middle Name

Last Name*
Fourth Campers Date of Birth*
Fourth Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Fifth Campers Name

First Name*

Middle Name

Last Name*
Fifth Campers Date of Birth*
Fifth Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Sixth Campers Name

First Name*

Middle Name

Last Name*
Sixth Campers Date of Birth*
Sixth Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Seventh Campers Name

First Name*

Middle Name

Last Name*
Seventh Campers Date of Birth*
Seventh Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Eighth Campers Name

First Name*

Middle Name

Last Name*
Eighth Campers Date of Birth*
Eighth Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Ninth Campers Name

First Name*

Middle Name

Last Name*
Ninth Campers Date of Birth*
Ninth Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Tenth Campers Name

First Name*

Middle Name

Last Name*
Tenth Campers Date of Birth*
Tenth Campers Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
Campers Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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I would like to opt in to recieve updates on promos, speicals and more!*
No
Yes
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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Guests may not leave before 5:00 PM without being accompanied by a parent, guardian, or one of the following authorized individuals *
Please Check if the following applies to your campers.
My child(ren) have no special problems or medical needs of which the staff should be aware.
My child(ren) are in need of special care including medication or other specific care:
There is food or drink that my child(ren) should not receive
My Child has allergies you should be aware of
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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