2023 Nature Explore Camp (Ages 6-8)

Please indicate any allergies or medical conditions

• Food Allergies
• Bee Stings
• Asthma
• Poison Ivy
• Other
• N/A

Please check any physical or other limitations that may apply to your child.

• Glasses/Contact Lenses
• Hearing/Speech Impairment
• Other
• N/A

Please indicate your child's t-shirt size

• Youth X-Small
• Youth Small
• Youth Medium
• Youth Large
• Adult Small
• Adult Medium
• Adult Large
• Adult X-Large
• Other

Fee

Photo Release: I do hereby consent and agree that Winnie Palmer Nature Reserve and its employees, or agents have the right to take photographs, videotape, or digital recordings of the child(ren) indicated above and to use these in any and all media, now or hereafter known, and exclusively for the purpose of Winnie Palmer Nature Reserve. I further consent that my name and identity may be revealed by descriptive text or commentary. I do hereby release to Winnie Palmer Nature Reserve and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration.

I do hereby agree to the photo policy and agree to have the child(ren) listed above photographed.

• Yes
• No

Release of Liability: I do hereby give consent for the child(ren) listed in this registration to participate in the Winnie Palmer Nature Reserve Programming Program administered by the Winnie Palmer Nature Reserve Staff and Saint Vincent College Students. I understand the types of activities that the program involves, including physical activities, may involve risks or physical injury. By signing this form, I understand that the Winnie Palmer Nature Reserve and Saint Vincent College cannot safeguard against all such injuries and expressly agree to assume risk of and, to the fullest extent permitted by law, waive and release the Winnie Palmer Nature Reserve, its officer, directors, agents and employees from any claim of liability for personal injury and any other loss, damages or injury incurred by my child during the camp.

I do hereby confirm that I have visited the link above and read and understand the Indemnity Agreement and agree to the terms held within.

• Yes
• No