=
=
![](3D"RegistrationPacket_files/image002.jpg")
=
Youth Wakeboarding Camp
Registration Form
Dear Camper:<= /b>
Included are the Liability forms, a medical release fo= rm and a registration form. Please f= ill these forms out and mail them back. (We suggest that you may want to make a copy of them for yourself.)<= span style=3D'mso-spacerun:yes'> Also included is a camp guide and checklist for you to keep.
What needs to=
be
done:
- Fill out:
- Liability forms #1 and #2
- Registration form
- Medical Release form (if camper=
is
under the age of 18)
- $200 Deposit per session per camper. (This is a b= ooking fee and will be applied to the total fee)
- &nb= sp; Endless Wakes LLC
- Cancellation =
Policy
Please understand that these policies are in place for= a reason, and we have to abide by them, no matter what the circumstances.
If you have to cancel your camp registration, here is = our policy:
&nbs= p; If you cancel two weeks prior to your start date, you will receive back a full refund.
If you cancel inside of the= two weeks prior to your start date you will receive a full refund minus your deposit of $200 per session per camper.
If we can fill your spot on= the boat inside of the two weeks we will give you a full refund, if not, we will keep the $200 deposit.
I have read a= nd accept the cancellation policy &nb= sp; Signature________________________= _______
Name of student: _________________________________ Ses= sion Dates: _____________________
T-shirt size: ____________
Deposit amount: __________ Check # ___________
Balance of = &nb= sp; ________
Extras &nbs= p; &= nbsp; __= ______
Total = ; &n= bsp; $_______ balance to be sent two weeks prior to camp date.
![](3D"RegistrationPacket_files/image004.gif")
. &= nbsp; &nbs= p; =
![](3D"RegistrationPacket_files/image006.gif")
= =
![](3D"RegistrationPacket_files/image008.gif")
Youth Wakeboarding Camp
Dear Parent/Guardian:=
&nbs= p; If y= our son/daughter is below the legal age of consent (18 years of age). T= he law requires that we have your permission to give medical service should the ne= ed arise. Your signature on the consent form will authorize us to proceed with the care of the lesser types= of medical problems that may occur. In the event of any major health problems, we will notify you as promptly as possible and follow your instructions.&nbs= p; If we are unable to contact you or your alternative listed below, yo= ur child will be taken to the nearest emergency room facility.
Name of student:_____________________________________________________Age:_________B= irth date:_______________
Address:_____________= ___________________________________________________________________________= ________
City:________________= _________________________________________State:____________Zip:____________= ___________
Parents name:___________________________________________________Print Name:________________________________
Home Phone:_____________________________Work Phone:_________________________Cell Phone:___________________
IN CASE OF EMERGENCY,
PERSON TO CONTACT IF PARENTS OR GU= ARDIAN CANNOT BE REACHED
Emergency Contact______________________________________________Print Name:__________________________________
Home Phone____________________________Work Phone:__________________________Cell Phone:_____________________
Emergency Contact:_____________________________________________ Print Name:__________= ________________________
Home Phone:___________________________Work Phone:__________________________Cell Phone:______________________
Does your child have = any sever medical problems that we should know about? (For example: asthma, allergies to drugs, heart trouble, epilepsy, diabetes, physical disability etc?) Please specify.
Has your child had any serious illness in the last three years?&n= bsp; □ No □ Yes If yes, please explain___________________________
Is your child taking = any medications or behavioral drugs at this time? □ No &n= bsp; □ Yes If yes, please explain____________________
_____________________= ___________________________________________________________________________= ____________
Can we contact your d= octor for medical reports? &= #9633; No &= nbsp; □ Yes
Doctor:______________= ___________________________Phone:_____________________________Hospital:____= _______________
Please list any other information of importance:________________________________________________________________= _____
MEDICAL INSURANCE INFORMATION (PLEASE ATTACH A COPY OF MEDICAL CARD)
Name of the Insurance Company:___________________________________________________________________= ___________
Insurance Company Phone Number:____________________________________________________________________= ________
Patient Record Number:____________________________________________________________________= __________________
Policy Number:____________________________________________________________________= _________________________
Bill/Other Information:_________________________= _____________________________________________________________
I do hereby authorize= the performance of medical examinations and necessary treatments (including tes= t, x-rays, drugs, etc…) as may be deemed advisable or necessary by the physician in attendance. This consent shall be in effect for the period of time that my son or daughter participates in any Endless Wakes LLC sponsored activities. If an emergency arises requiring a= major surgical procedure, the camp director will attempt to reach me and to be gu= ided by my wishes; but if I cannot be reached, I authorize the attending physici= an to act as medical judgment may dictate.
Parent/Guardian’= ;s signature:_________________________________________________________________= __________________
Print name:_______________________________________________________Date of Consent:__________________________= _
![](3D"RegistrationPacket_files/image010.gif")
![](3D"RegistrationPacket_files/image012.gif")
= &nb= sp; =
&nbs= p; &= nbsp; &= nbsp; &nbs= p; &= nbsp;