Nature Kids Fall 2021 Registration

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Please find COVID-19 Protocols here: https://drive.google.com/file/d/1rktpKCb8Cslq81rgO8cwqJbzVC6yfMKK/view?usp=sharing
Please find program policies here: https://drive.google.com/file/d/1OUSiad5Gd-g7qHX5w-xsAFF5cwYKgqn9/view?usp=sharing

Parent/Guardian Full Name *

Parent/Guardian Email Address *

Parent/Guardian Phone Number *

Parent/Guardian Alternate Phone Number

Participant Full Name *

Participant Address *

Street address, Unit #, City, Postal Code

Participant's Health Card Number *

Participant's Age *

Emergency Contact Name *

Emergency Contact Phone Number *

Relationship of Emergency Contact *

Who will be picking the participant up? *

Please list the names of all that apply, including their relationship to the participant.

Does the participant have any allergies? Please list. *

Does the participant have any medical conditions that we should be aware of? Please list. *

Is there anything else you would like to tell us to ensure this is a great experience for your child? *

Photo Release: Photos may be taken throughout the session and used (without names) for promotional purposes. If you are comfortable having your child's photo taken, please select "YES" in the check box below. *

YES, I give permission for photos to be taken.

NO, I do not give permission for photos to be taken.

Required

Waiver: By clicking below, I hereby release Green Venture from all claims or damages arising from participation of the applicant hereon during any program or in any location where a program is held (ie. field trips to Veevers Park, Davis Creek), except where such damage or injury results from the gross negligence of Green Venture and/or it's employees. *

Permission is hereby granted to Green Venture and its representatives to transport or arrange for an ambulance for my child(ren) if medical treatment is deemed necessary.

I have read and agreed to the COVID-19, Inclement Weather, Behavioural, Cancellation, and Pick Up policies. *

Yes

How did you hear about the Nature Kids program?

Email from Green Venture

Facebook

Instagram

Twitter

Word of mouth

Other:

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I am the parent or legal guardian of the participant. I am of legal age and freely signing this agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies.

Parent or Legal Guardian E-Signature: By typing your name in the box below, you recognize that this e-signature represents that of a legally binding signature. *

First Name, Last Name, and Date.

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