BLOCK2TheFuture Overnight Stay Crypto/STEM Program
Full Name (1st Parent/Guardian) *
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Cell Number (1st Parent/Guardian) *
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Email Address (1st Parent/Guardian) *
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Full Name (2nd Parent/Guardian ) *
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Cell Number (2nd Parent/Guardian) *
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Email Address (2nd Parent/Guardian) *
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Emergency Contact Name *
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Emergency Contact Number *
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Emergency Contact Email *
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Number of Children Attending Program *
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Please list the Children's Full Names and Ages *
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Does your child have any allergies? *
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If yes, please list what they are allergic to.
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The ship has steep ladders and areas that require extra attention at all times. *
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Due to the unique location of the event, natural noises (such as creeks, rocking of the ship, sea sounds) will be audible during the night. Do you wish to proceed? *
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What to Bring: The overnight program requires attendees to bring a Sleeping Bag, Pillow, Flashlight, Toiletries, Hand Towel, Jacket, Water Bottle, Good Walking Shoes, Earplugs for light sleepers. *
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What not to Bring: Weapons of any kind, Scouts 10 essentials kit are not needed, Alcohol Lighters or matches(under 18), Any unnecessary Electronic Devices such as hair dryers or laser pointers, Open toe shoes. *
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I, legal guardian or parent, understand that by registering for and attending the BLOCK2TheFuture event on the USS Hornet, I am agreeing to the terms of this Authorization, Waiver & Release both on behalf of myself and my child(ren) who attend with me or whom I permit to attend. I give permission for my child(ren) to participate in activities associated with the BLOCK2TheFuture event on the USS Hornet and I permit them to attend on April 4th, 5th and/or 6th. I expressly grant my permission for myself and my child(ren) to be photographed, audiotaped or videotaped at BLOCK2TheFuture event on the USS Hornet and for said photographs, video or audio content to be used by the BLOCK2TheFuture event as it deems fit, in BLOCK2TheFuture’s sole discretion. I understand BLOCK2TheFuture event on the USS Hornet shall own all intellectual property rights, if any, arising in connection therewith, and I further agree and acknowledge that neither myself nor my children shall receive (or be entitled to receive) any compensation from BLOCK2TheFuture for any such usage. I promise that my minor child(ren) (over 5 and under 14) shall not attend any BLOCK2TheFuture event on the USS Hornet without a parent, guardian or adult whom I authorize to be responsible for my child(ren). I will adhere to these requirements and agree to assume the risks of not having an adult accompany my minor teen to a BLOCK2TheFuture event on the USS Hornet if I allow my minor teen to attend without an accompanying adult. I understand that minors under 14 are not permitted to attend without an accompanying adult under any circumstances.I have read this Authorization, Waiver & Release form in its entirety, fully understand its terms, and have agreed to its terms freely and voluntarily without any inducement, assurance, or guarantee being made to me. I intend for my BLOCK2TheFuture event on the USS Hornet registration to be a complete and unconditional release of liability to the greatest extent allowed by law for all persons I have registered, including my minor child(ren). *
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