Urban T.O Outdoor Camp Registration

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Child's Full Name *

Child's D.O.B *

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Child's Health Card # *

Any Health Conditions? If yes, please explain. *

Parent/Guardian Name *

Email *

Phone *

Grade

Grade 4-5-6

Grade 7-8

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Select the appropriate dates *

Emergency Contact - Full Name *

Emergency Contact Phone # *

How did you hear about Urban T.O Outdoor Camp?

Release of Liability - I hereby promise to obey all rules and regulations of Urban T.O Outdoor Camp. Urban T.O Outdoor Camp will not be liable for any injuries, death or for loss of, or damage to any equipment. NO CLAIM – I hereby agree that I shall make no claim and bring no action, suit or proceedings for any and all damages, losses, liabilities or costs in any manner suffered or incurred as a result of my participating in the activities for which I have registered herein and I hereby release the permit holder, Urban T.O Outdoor Camp and their administration, the City of Toronto and the owner/occupier of the facility in which I participate from any and all damages, losses, liabilities or costs in this regard. I hereby give permission for Urban T.O Outdoor Camp to use photographs for the purpose of future marketing in either online or hard copy media. *

Release of Liability Accepted: By clicking on this box you are agreeing to the release of liability statement above.

Please send all payments to kronicksi@gmail.com *

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