ProjectFUN: Secrets of the Forest Registration
Your First Name *
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Your Last Name *
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Phone number *
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Email *
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Street Address *
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List the names and ages of those joining you *
Example: Mark, 34; Ezra, 7
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Health and Medical Concerns
Does anyone in your group have any medical, behavioral, or allergic conditions we should be aware of? If yes, than please tell us more below
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Is there anything you'd like us to know that will help ensure this is a positive experience for your family?
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Waiver and Release
Important Information *
In consideration of participating in Kestrel Educational Adventures programming and the use of land, boats, and/or facilities owned or leased by Kestrel Educational Adventures (hereinafter referred to as "KEA"), I, the parent or legal guardian of the “Student,” acknowledge and agree as follows:I understand that the Student and I both share the responsibility for the Student's safety. I have had the opportunity to ask questions about the activities and the risks of the program in which the Student will participate. I agree to obey all rules, regulations, and policies and agree to have the Student obey them. I affirm that the Student has no mental, psychiatric, or physical condition or limitations, other than those that have been disclosed to KEA in writing. I agree to provide written notice to KEA of any change in the Student's mental, psychiatric, or physical condition, while the Student is participating in KEA programming. The activities in which the Student may participate will depend on the program in which the Student is enrolled. These activities may be physically strenuous and may include, but are not limited to: hiking on uneven, rocky, and slippery terrain and in high grass and wooded areas; tree climbing; motorized vessel and other boat travel; fishing, including fishing from watercraft in close proximity to other participants; swimming and wading in fresh water and ocean water; cooking; fire building and use of fire; use of knives and other tools; building and sleeping in natural shelters; rock climbing; backpacking; camping and winter camping; skiing; snowshoeing; interacting with wildlife; and service projects. Some activities may take place outside of the Commonwealth of Massachusetts. I understand that the Student may engage in other activities not described above and that scheduled program activities may be substituted with other activities without prior notice.It is impossible to state every risk associated with KEA program activities; however, I understand the risks the Student may encounter include, but are not limited to: slipping; falling; being struck by or striking objects, persons or the ground; wave and tidal action; exposure to sharp objects, both natural and man-made; improper or malfunctioning equipment or structures; disease carrying or poisonous plants, insects, or animals; exposure to hot, cold, wet, and other potentially hazardous types of weather; hypothermia or hyperthermia (heat-related illness, heat exhaustion), sunburn, and dehydration; distance from comprehensive emergency medical care; physical contact with other participants; and interaction with outside vendors and members of the general public. I acknowledge that the risks involved in participation in the KEA programming, including any risks not herein identified and described, may cause or lead to injury, illness, death, or property damage. These and other risks are inherent to the activities and they cannot be changed or eliminated without altering the essential elements or quality of the activity. I acknowledge and understand that KEA cannot change or eliminate these risks. I acknowledge that the Student's participation in KEA programming is purely voluntary and I elect for the Student to participate in spite all known and unknown risks. I agree that the Student and I assume the risk of the activities in KEA programming, whether or not described in this form.I further acknowledge and authorize KEA staff to administer ibuprofen and/or antihistamine during an emergency situation if the aforementioned drug or drugs is likely to prevent serious injury or death. I further acknowledge that I have an obligation to disclose any and all Student allergies, including drug allergies, and understand Kestrel will withhold the administration of these drugs only if requested by the Parent / Guardian in advance. On behalf of the Student and myself, I hereby forever release, waive, and discharge KEA and each of KEA's agents, affiliates, employees, officers, directors, trustees, independent contractors, volunteers, and all other persons or entities acting under KEA's direction and control (collectively "the Released Parties") from any claim, right, or cause of action, including but not limited to, any claims for injury, property damage, wrongful death, breach of contract, loss of consortium, or any other type of lawsuit, that I or the Student may have arising, in whole or in part, from the Student's enrollment or participation in KEA programs, including claims, rights, or causes of action caused by the negligence of the Released Parties. I covenant, promise, and agree not to pursue any claim or lawsuit against the Released Parties, collectively or individually, for any liability, claim, or expense in any way associated with the Student's enrollment or participation in the KEA program or the use of any equipment or facilities owned or operated by any of the Released Parties. I certify that the Participant has adequate insurance to cover any injury or damage caused or suffered while participating in the KEA program, or else I agree to bear the costs of such an injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition the Student may have that may increase the risks of participation in KEA programs or may increase the magnitude of potential injuries.I further agree to defend and indemnify the Released Parties (to pay or reimburse them for money they are required to pay) for all costs, including attorney's fees and court costs, with respect to any and all claims brought on behalf of the Student arising from the Student's enrollment or participation in the program or the Student's use of equipment or facilities under the control of the Released Parties.I agree that the substantive law of Massachusetts (but not any law that would apply the laws of another jurisdiction) governs this document and any dispute or lawsuit I or the Student has with the Released Parties. Any mediation, lawsuit, or other proceeding must be filed or entered into only in Massachusetts. Any portion of this document deemed unlawful or unenforceable is severable and shall be stricken without any effect on the enforceability of the remaining provisions. I give permission to KEA staff and volunteers, as well as visiting press reporters and members of organizations providing funding, to photograph the Student, and to use these photographs to promote KEA and its activities. The possible uses of photographs may include (but are not limited to) newspaper or newsletter articles, slide shows, brochures, short films, digital marketing, and the web.I understand that if KEA cancels a program for any reason, I am entitled to a credit or refund worth the full value of the cancelled class or program. I also understand that I am entitled to a credit or refund worth the full value of the class or program when I cancel more than two weeks in advance of the start of the first class or program. I further acknowledge that KEA does not offer refunds, rebates or discounts for partial or incomplete attendance, or for cancellations made within two weeks of the start of the first class or program.I have carefully read, understand, and voluntarily sign this document. I understand that I am surrendering certain legal rights owned by me and by the Student. I hereby warrant that I have legal authority to act on behalf of the Student. I agree, on my own and on behalf of the Student, to the terms and conditions in this document.
Electronic Signature *
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Additional Information
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