Parent or Guardian Name *

First Name

Last Name

Parent/Guardian Phone *

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Parent/Guardian Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name *

First Name

Last Name

Emergency Contact's Phone Number

(###)

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Name of Child Attending Camp *

First Name

Last Name

Medical Release Waiver *

In the event that you and/or your child may require medical attention and the emergency contact named on this form cannot be contacted, Dreama Team Way medical staff personnel will be hereby authorized to take whatever action is deemed necessary in their judgement for the health of you or the aforesaid child/participant. I agree that I am solely responsible for payment of all costs resulting from the rendering of medical and ambulance services. If your child will be taking medication during program hours, we require a note from the parent/guardian giving us permission to administer the medication. All medication must be in the original container.

Click here if you agree with the above statement.

Personal Release Waiver *

I understand that the registered activities and services may have an element of hazard or inherent danger and I take full responsibility for my and/or children’s actions and physical condition. I agree to indemnify and hold the Dreama Team Way and its Directors, Officers, Agents, Staff, and Employees from liability, loss, cost, or expenses (including attorney fees, medical, and ambulance costs) that may incur in registered activities of camp.

Click this box if you agree with the above statement.