RHW Winter 1 OUTDOOR ACTIVITY SESSIONS
REGISTRATION FORM - PLEASE COMPLETE FORM IN ITS ENTIRETY

To pay call 860-974-1122


Parents/Guardians are required to be with children at all times during our programs. Remember that part of children learning is their ability to figure things out on there own and adults watching from a distance at times. We ask that as part of our program you let your kids participate to the fullest by watching from a distance.
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Email *
Childs(rens) Name First and Last and Age/Grade *
Parents Name First and Last *
Phone Number *
Email Address
Mailing Address *
Session Attending January 12 - Gr. PreK-8
Session Attending January 19 Gr. PreK -8
Session Attending January 26- Gr. PreK -8
Session Attending February 2 - Gr. PreK-8
Session Attending February 9 - Gr. PreK-8
Minor Participant Assumption of Risk WINDHAM COUNTY 4-H FOUNDATION, Inc(dba WINDHAM-TOLLAND 4-H CAMP & RAGGED HILL WOODS)                                                   Assumption of Risk                                                                    I, in my legal capacity as parent/guardian of the minor(s) named above, acknowledge and agree that any use of WINDHAM COUNTY 4-H FOUNDATION, Inc  (dba WINDHAM-TOLLAND 4-H CAMP AND RAGGED HILL WOODS)facilities, services, equipment and premises (“Facilities”) and any participation in WINDHAM COUNTY 4-H FOUNDATION, Inc (dba WINDHAM-TOLLAND 4-H CAMP AND RAGGED HILL WOODS)programs and activities (“Programs”) comes with inherent risks including, but in no way limited to: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and (5) sickness or disease including, without limitation, COVID-19. I voluntarily, for myself and Minor, accept and assume full responsibility for these risks as well as any and all other risks of the use of Facilities and participation in Programs. I agree that I have full knowledge of the nature and extent of all such risks and am not relying on all such risks being described in this document.      In further consideration of the use of Facilities and participation in Programs, I, in my legal capacity as parent/guardian of Minor, agree on behalf of myself and Minor to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, suits, liabilities or costs of any nature whatsoever, including claims of negligence, arising out of or in any way related to the use of Facilities and participation in Programs. *
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