Junior Gulls Camp Info Form
Thank you for your interest in our Chocolate Camp! Campers will be accepted in the order that applications are received. All information given will be kept confidential and is for the sole purpose of providing quality care and an excellent experience for your child.
Email address *
Which session are you interested in? *
Required
Camper's Full Name *
Your answer
Camper's Age *
Your answer
Does the Camper have any allergies? *
If the camper has any allergies, please provide additional information. Please note, that if your child has a nut allergy, LGC is NOT a nut free facility.
Your answer
Please list any medical conditions your child has that we should be aware of (allergies, asthma, diabetes, etc.). If none, please enter none. *
Your answer
Will your child need medication while at camp? If yes, please explain. *
Your answer
Does the camper require any special assistance? (This would include anything that you think our team should be aware of so we can make the camp experience as awesome as possible.) *
Your answer
Emergency Contact #1 (Name, Phone Number, Relation to Camper) *
Your answer
Emergency Contact #2 (Name, Phone Number, Relation to Camper) *
Your answer
Your child's T-shirt size: *
Your answer
Caregivers E-mail (Invoice will be sent here.) *
Your answer
WAIVER AND RELEASE: Consideration: I acknowledge the personal benefits accruing to my child by reason of participation in the above described event and am aware of the activities which my child will be involved through said participation. Release / Indemnification: I hereby, in consideration of such benefits and other good and valuable consideration received, consent to the above listed participation and release absolutely, forever discharge, hold harmless and covenant not to sue Laughing Gull Chocolates, LLC, and camp location, its directors, employees, agents, volunteers, and affiliates ("camp location") from any and all present or future liability, claims, demands, actions or rights of action, whether asserted by me or a third party arising out of my child's participation in the event activities (the "Claims"). I agree to indemnify and hold harmless Laughing Gull Chocolates, LLC and camp location for any such Claims brought by me or a third party from any costs associated with defending or litigating such claims, including but not limited to attorney fees, costs and legal expenses. Assumption of Risk: I am aware of the risks associated with participation in the above event and do hereby voluntarily assume full responsibility for any risk of loss, property damage or personal injury, including death, that may result from participation in event activities. Medical Emergency: In the event of an injury or medical emergency, I understand that the camp instructor, not Laughing Gull Chocolates, LLC and camp location, will be responsible for the medical care of all attendees. It will be the camp instructor's responsibility to assess medical needs, obtain and consent to appropriate medical care, transport persons in need of medical care and contact parents or guardians of minors. I release Laughing Gull Chocolates, LLC and camp location from any and all liability related to medical treatment. In addition, I assume the risk and financial responsibility for any injury resulting from the attendee's participation in all camp events. Understanding: I represent and acknowledge that I have completely read and understand this document and all its terms and all matters referred to herein, and I signed voluntarily as my free act and deed, that I have had ample opportunity to obtain the advice of counsel and that, by signing this document, I understand that I am relinquishing legal rights and remedies that may have otherwise been available to me. I understand that this Waiver and Release shall be construed as broadly and inclusively as is permitted by applicable law and agree that if any portion of this document is held invalid, the remaining shall continue in full force and effect. To the extent the restriction on filing lawsuits is deemed unlawful, I agree to submit any Claims to a mediation organization for binding resolution. Media Consent: I give my consent and permission for the taking of photographs and/or video of my child during the described event and waive and/or assign any and all rights (including copyright) in such media to Laughing Gull Chocolates, LLC, as the sole owner of such media, shall have exclusive rights to control and determine the use, display, performance, reproduction and dissemination of any such photographs and/or videos. CAUTION: READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS IS A GENERAL RELEASE AND INDEMNIFICATION OF CLAIMS. *
Required
Refund/Cancellation/Pickup Policy: Payment is due in full upon receipt of invoice. Payments are non-refundable. A pick-up authorization form will be sent with your confirmation and must be completed prior to the beginning of camp.
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