Phone Number*

I’m registering my child for:*

Child's Full Name*

Child's Date of Birth*

Saskatchewan Health Card Number*

In case of emergency, the child care service will contact the following physician for medical treatment: Please include Physician's Name, Address and Phone Number*

Provide the names, phone number, email and relationships of two other persons to contact in case of emergency:*

Medical History*

Please provide any further information regarding your child's medical history we should be aware of.

Does your child have any known allergies?*

If Yes, what are they and what are your child’s reactions?

Are there any restrictions on the kind and/or amount of physical activity in which your child may participate?*

If Yes, please identify.

Please advise of any special dietary needs

Emergency Medical Release Should it be necessary for your child to have medical treatment while participating in The Wild Sky Learning Forest Kids Camp, and a parent cannot be reached, your signature gives the Wild Sky personnel permission to use their judgment in obtaining medical service for the child and gives permission to the physician to render medical treatment deemed necessary and appropriate. Parent’s/Guardian’s*

I give consent for my child to participate in the above activities, and I execute the above liability release on their behalf.*

How did you hear about the Wild Sky Learning Forest Kids Summer Camp?*

Terms of Agreement Photo Release I hereby give permission for my child to be photographed during the ForestKids Summer Camp. I understand the photos will be used to keep a journal of activities, to share during powerpoint presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of the ForestKids Summer Camp and its affiliates.*

Transportation Release I hereby give permission for the transportation of my child for official WILD SKY ADVENTURE LEARNING FOREST KIDS CAMP activities by modes of transportation agreed to by the camp organizers. WILD SKY ADVENTURE LEARNING CENTRE and its co-organizers are not responsible for lost or damaged personal property. All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per physician orders. Children's’ photos and quotes may be used for publicity purposes. In case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by a Certified Emergency Personnel (i.e. EMT, First Responder, and/or Physician).*

Liability Release & Parental Consent. In order for my child to participate in the Forest Kids Camp, I hereby waive, release, and discharge any and all claims for damages for personal injury, and property damages or which may hereafter occur to me as a result of participation in said event. This release is intended to discharge in advance Wild Sky Adventure Learning, Northern Lights Bluegrass and Old Time Music Society Inc, its officials, officers, employees, volunteers, and agents from liability, even though that liability may arise out of perceived negligence on the part of persons mentioned above. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees. I give consent for my child, to participate in the above activities, and I execute the above liability release on their behalf.*