Registration Form
Shark Wake Park Camps 2024
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Email *
Last Name: Parent/Legal Guardian (1) *
First Name: Parent/Legal Guardian (1) *
Phone Number: Parent/Legal Guardian (1) *
Last Name: Parent/Legal Guardian (2) *
First Name: Parent/Legal Guardian (2) *
Phone: Parent/Legal Guardian (2) *
Primary Address - Street *
Primary Address - City *
Primary Address - Zip *
Emergency Contact(s): First & Last Name *
Emergency Contact: Phone *
Authorized Sign Out List *
Last Name: Child 1 *
First Name: Child 1 *
Allergies: Child 1 (List N/A if none) *
Medications: Child 1 (List N/A if none) *
Last Name: Child 2
First Name: Child 2
Allergies: Child 2
Medication: Child 2
Last Name: Child 3
First Name: Child 3
Allergies: Child 3
Medication(s): Child 3
Parent Consent
I hereby authorize Shark Wake Park to act for me according to their best judgment in any emergency requiring medical attention and hereby waive and release the camp staff and Shark Wake Park from any and all liability for any injuries or illness incurred while at camp. I understand that participation in various sports involves motion and as such carries with it the risk of injury. The camp is not responsible for personal items that are lost, stolen or damaged. All medical expenses incurred will be the responsibility of the camper’s family. In lieu of medical certificate signed by a medical doctor, I have no knowledge of any physical or mental impairment that would be affected by the named camper’s participation in the camp program. I also understand that the camp retains the right to use photographs, videotapes, motion picture recordings, or any other record of this event for publicity, advertising, or any legitimate purpose.
I have read, understand and agree to the Parent Constent listed above. (Type first & last name for electronic signature authorization) *
Palm Beach County: COVID-19 Release of Liability
I have read and agree to the above COVID-19 release of lability, from Palm Beach County (First & Last Name) *
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