South Lake Tahoe Bug Camp Waitlist Form
In various outdoor locations around South Lake Tahoe, young campers will look under logs, among plants, and in tree bark in search of hidden insects. They will also learn what these bugs eat and their important jobs in the ecosystem.

Note: Drop off location varies by day and often includes spots like Bijou Community Park, Tallac Historic Site, and Rabe Meadows.

Ages: 6-8
Dates/Times: July 10-13, Monday-Thursday, 9:00am - 1:00pm.  

**South Lake Tahoe Bug Camp is currently full. Please fill out the name of camper, birth date, and your contact info to be notified of any cancellations. You do not need to fill out the rest of the form unless you are notified that space is available.
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Name of Camper *
Participants Birth Date *
Campers Ages 6-8
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Guardian Name *
Guardian Relation *
Email Address *
Guardian Phone Number *
Include area code
Secondary Guardian Name
Secondary Guardian Relation
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Secondary Guardian Phone Number
Include area code
Address (City, State, Zip)
Please List TWO emergency contacts
Please include name and phone number
Others authorized to pick up child(ren) from program
Please include name and phone number
How did you learn about our camps?
Physicians Name and Phone Number
Allergies/Medical Conditons
Please include any special instructions
Medical Insurance Provider
Policy Number
Camper's Last Tetanus Shot
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Is there anything specific we should know about your camper?
Consent to Treat
When I, the legal Guardian(s), cannot be located after reasonable efforts under the circumstances, I/we give my consent to seek medical care for the above name participant(s), in case of serious illness, accident, or other emergency requiring immediate hospitalization, medical attention, or surgery. I authorize any qualified Tahoe Institute for Natural Science (TINS) employee, volunteer, or medical personnel to render necessary emergency care for the above named participant(s). I/we also agree to be responsible for all medical costs incurred on the participant’s(s’) behalf. Authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California and NRS.129.040 of the Nevada Revised Statutes.Please select "Yes" to verify you have read, understand, and agree with the Consent to Treat
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REFUND/ PAYMENT DUE POLICY
No refunds will be given for one-time classes, trips, tours, or special events. Full refunds will be given if TINS cancels a program. A partial (50%) refund is given only if requested 30 days before the first day of camp/class. Or you can receive a full credit toward another camp or TINS membership if TINS is notified 30 or more days prior to the first day of camp/class. Late cancellation, or if your cancellation causes TINS to have to cancel the camp/class no refund will be given. Payment is due at registration to reserve your spot. Please make checks payable to Tahoe Institute for Natural Science. Please select "Yes" to verify you have read, understand, and agree with the refund Payment Due Policy.
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AGREEMENT, WAIVER AND RELEASE
I, the legal Guardian(s),  have carefully read the description(s) of the program(s) for which I/we are registering, and in consideration for being permitted by the Tahoe Institute for Natural Science (TINS) to participate in the above activity(ies), I hereby waive, release and discharge any and all claims for damages for personal injury, death or property damage which I may have, or which may hereafter accrue to me, as a result of participation in any and all activities during camp. This release is intended to discharge in advance the Tahoe Institute for Natural Science, its officers, employees, and any contractors or agents from any and all liability arising out of or connected in any way with my participation in said activity, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. It is understood that this activity involves an element of risk and danger of accidents, and knowing these risks I hereby assume those risks. It is further agreed that this waiver, release and assumption of risk is to be binding on my heirs and assigns. I agree to indemnify and to hold the above persons or entities free and harmless from any loss, liability, damage, cost, or expense which they may incur as the result of my death or injury or property damage that I sustain while participating in said activity. Please select "Yes" to verify you have read, understand, and agree with the Agreement Waiver and Release .
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PARENTAL CONSENT (to be completed & signed by parent/guardian if applicant is under 18 years of age)
I, the legal Guardian(s),  hereby consent that my son/daughter shall participate in the above activity, and I hereby execute the above Agreement, Waiver, and Release on his/her behalf. I understand that this activity may include van or bus transportation & field trips, and will encompass a wide variety of indoor and outdoor games, sports & activities. I state that said minor is physically able to participate in said activity. I hereby agree to indemnify and hold the persons and entities mentioned above free and harmless from any loss, liability, damage, cost, or expense which they incur as a result of the death or injury or property damage that said minor may sustain while participating in said activity. Please select "Yes" to verify you have read, understand, and agree to Parental Consent.
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Assumption of the Risk and Waiver of Liability Relating to Coronovirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. The Tahoe Institute for Natural Science (TINS) has put in place preventative measures to reduce the spread of COVID-19; however, TINS cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending TINS camps could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending TINS camps and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at TINS camps may result from the actions, omissions, or negligence of myself and others, including, but not limited to, TINS employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the TINS camps or participation in TINS programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless TINS, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of TINS, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any TINS program.
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Agreement to COVID-19 Prevention Measures
I will not bring my child(ren) to camp if either my child(ren), or anyone in my household, has/have shown any symptoms of COVID-19 during the three days prior to each camp date. Symptoms may include fever, cough, shortness of breath or difficulty breathing, chills, muscle pain, headache, sore throat, or new loss of taste or smell. I understand that any child that shows or develops symptoms during the course of a camp will be required to leave the activity, and this may require a parent or guardian to return immediately to the location of the camp to provide transportation. If any child shows symptoms of possible COVID-19 infection, that child will be required to stay home in accordance with Center for Disease Control Guidelines; TINS will issue a full refund for any dates the child misses due to illness. I understand that my child will be asked to conform to safe behavior and hygiene practices during camp.
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PHOTOGRAPHIC RELEASE
I, the legal Guardian(s),  give the Tahoe Institute for Natural Science the right and unrestricted permission to copyright and/or use and/or publish (1) the image or likeness on video, and (2) photographic pictures of the participant named on this form, including but not limited to, the promotion of the Tahoe Institute for Natural Science and its programs. Please select "Yes" or "No"  to verify you have read, understand, and agree to Photographic Release.
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I, the legal Guardian(s),  have carefully read this agreement, waiver, and release and fully understand its contents. I am aware that this is a release of liability, and a contract between the Tahoe Institute for Natural Science and myself, and I am signing it of my free will.
Guardian, please enter your name below
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