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Registration Form
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Family Information
Parent’s Name
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First
Last
Address
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City
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Zip
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Primary Phone
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Please make sure that we have a number where a parent or guardian can be reached during camp.
Emergency Phone
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Email
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Any learning accommodations that we should be aware of? Any food or insect allergies?
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Additional Comments or Requests
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Participant(s)’ Information
Child’s Name
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First
Last
Age
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Date of Birth
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Program
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Select a Program
2023 Winter Jr. League
2023 Spring Break Camp
Other
Program Name i.e. Winter League
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Waivers and Agreements
Please read the following waivers and agreements carefully.
They include release of liability and waiver of legal rights, and deprive you of the ability to sue certain parties. By agreeing electronically, you acknowledge that you have both read and understood all text presented to you as part of the registration process.
LIABILITY WAIVER:
While my child is participating a Mariners Point golf class, I acknowledge and assume all the foregoing risks on his/her behalf and likewise accept personal responsibility for any injury or damages that may occur. I release, waive, discharge and covenant not to sue Mariners Point VBGolf LLC administrators, agents, sponsors, other participants, advertisers, and owners/lessors of premises used to conduct the activities. I have read the above waiver and release, and understand that I have given up substantial rights by signing it, and sign it voluntarily.
I agree to the Liability Waiver
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Accept
MEDICAL RELEASE:
I fully realize that injury or illness to my child may result from or during participation in the youth camp. In case of injury or illness, I give permission for my child to be given medical treatment as deemed appropriate. I further give permission for the information provided on this form to be shared with appropriate medical personnel. I further give permission for and grant authority to the camp representatives to sign on my behalf the Notice of Privacy Practice that patients are required to receive in accordance with federal law. I understand and acknowledge that I will be responsible for any medical bills incurred by my child.
I agree to the Medical Release
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