CAMP REGISTRATION -
FAmily rate

Adult Name #1 *

First Name

Last Name

Adult Name #2 *

First Name

Last Name

Child Name #1 (17 years old and below) *

First Name

Last Name

Child Name #2 (17 years old and below) *

First Name

Last Name

Camp Waiver *

I/We the above named participant(s) give my/our voluntary consent to my/our participation in the CEAC Camp Kuriakos activities and agree to all conditions of enrollment/participation in this camp. Furthermore, I/we authorize the CEAC Camp Committee Staff to approve and obtain any and all medical attention and medical staff in case of a medical emergency; with the understanding that all reasonable attempts have been made to consult with myself beforehand except in the case of minor illness and/or first aid where deemed appropriate; with the understanding that I/we will take full responsibility for any additional expenses that may result from such services. Furthermore, I release CEAC; its trustees, directors, corporation members, staff, and agents from any loss, personal injury, accident misfortune or damage to the above named or my/our property; with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named. I/We understand that CEAC, its staff or agents reserve the right to dismiss a participant who is in their opinion a hazard to the safety and well-being of others and/or who appears to have rejected the reasonable guidelines of the camp activities. I/We agree to allow the use of photos and/or videos of the above named participant(s) in promoting the camp or camp activities and programs. I have read all the information in this form including this waiver and accept the conditions of enrollment/participation in this camp with the full knowledge that this form with the "Agree" option checked may be used as a legal document in any court of law.

Agree

Date *

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DD

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