Please fill and submit below form I am *a parenta GuardianParent / Guardian informationFirst Name *Last Name *Email Address *Phone Number *Use this information as Emergency Contact *Use this information as Emergency ContactYesNoAdd 2nd Parent / Guardian Information *Add Parent InformationYesNoParent / Guardian information (2)First Name *Last Name *Email Address *Phone Number *Use this information as Emergency Contact *Use this information as Emergency ContactYesNoEmergency ContactPrefixMr.Mrs.Ms.Mx.MissDr.Prof.First NameMiddle NameLast NameEmergency Contact Person's Email Address *Emergency Contact Person's Phone *Emergency Contact Person's relationshipEmergency Contact Person's relationshipFatherMotherOtherPleasse explaine relationship *Participant's infoFirst Name *Last Name *Email AddressAge of participant *School Grade *Camp Week of Participation *Week 1: July 8, 2023 – July 12, 2023Week 2: July 15, 2023 – July 19, 2023Please Select the Week/sMessage0 / 150With use of this Web Form *You agreedWith WWBMMC's privacy policy and cookie policy.By Fill and Submiting this Form *I hereby give my permissionfor my child(ren) to participate in the WWBMMC (the “Lake Monastery”) Summer Camp Program (“Summer Camp”).Photography Release: *I acceptI declineIn consideration of child(ren)’s participation at the Lake Monastery, and without any further consideration from the Lake Monastery, I hereby grant permission to the Lake Monastery, staff and affiliates to utilize my child(ren)’s appearance, performance or voice in any and all manner and media throughout the world for the purpose of promotion, reporting or publication. The Lake Monastery may use my child(ren)’s, likeness, voice and biographical material in connection with publication, promotion, exhibition and distribution of such material. I understand that no royalty, fee or any other compensation of any kind shall become payable to me by reason of such release and use of any photograph.Medical Consent: *I acceptI declineParticipation in any program which involves physical activity exposes the camper to certain risks and dangers. Accidents and injuries are always a possibility, and it is impossible to foresee and protect the camper from all conceivable dangers. I hereby affirm that my child(ren) has/have no conditions that would make it unsafe for him/her/them to participate in the camps program(s) selected. I understand that the Lake Monastery may exclude my child(ren) from Summer Camp in the event that I or my child(ren) fail to abide by the Lake Monastery’s health and safety protocols, disrupt, impede or interfere with the operations of the Summer Camp, or threaten the health, safety or welfare of other participants or Summer Camp staff, and that no refund of any fees will be made in such circumstances. Medical Consent: I understand that the Lake Monastery will make every effort to contact me in the case of an emergency. I give my permission for the Lake Monastery to administer any medications needed and to provide and arrange for and consent to any necessary medical treatment for my child(ren) while at the Lake Monastery, including onsite and offsite emergency care. I accept responsibility for the costs of all such medical treatment.By signing this Waiver: *I have read and comprehended the consent outlined above and below, and I have affixed my signature to this document.By signing this Waiver and Release of Liability, with full appreciation of the risk involved, on my own behalf and on behalf of my child(ren), I hereby voluntarily release and forever discharge the Lake Monastery, its trustees, officers, employees, agents, insurers and contractors from any and all legal or financialresponsibility for any personal injury, disability, illness, damage, medical expense or death, arising from or related to my child(ren)’s participation in Summer Camp. I agree, for myself and my child(ren), not to make any type of legal or equitable claim on the Lake Monastery, or any of its trustees, officers, employees, agents, insurers or contractors with respect to any injury I or my child(ren) may suffer, whether or not it arises through the negligence, omission, default or other action of anyone affiliated with the Lake Monastery, including other campers. I further agree that if any such claim is made, I will indemnify and defend the Lake Monastery with respect to any such claim, injury or damage.Signature of Parent/Legal Guardian *Start signing your signature hereYour browser does not support e-Signature field.Submit
