Participant/Volunteer Information Participant Role Is the Volunteer a minor? Parental Acknowledgment for Minors * Required I understand that my child must be supervised by me or another responsible adult during the event, and that the supervising adult must also register separately as a volunteer.
Participant's Name * Required
First
Last
Participant's Date of Birth * Required Email * Required This email will be used for all event updates.
Address * Required
Participant's Guest Information * Required Click + symbol on the right to add more names. Please list ALL guests of participant. Guests will not be permitted access if not on list. Please do not include registered participant.
Additional Information Participant Disability * Required
Ethnicity * Required Please select all that apply
Releases and Disclosures COVID Information * Required While participating in events held or sponsored by Wayfinder Family Services, consistent with CDC guidelines, participants are encouraged to practice hand hygiene, “social distancing” and wear face coverings to reduce the risks of exposure to COVID-19. Because COVID-19 is known to be contagious and is spread mainly from person-to-person contact, Wayfinder Family Services has put in place preventative measures to reduce the spread of COVID-19. However, Wayfinder Family Services cannot guarantee that its participants, volunteers, partners, or others in attendance will not encounter COVID-19.
I acknowledge that my participation (or my child’s) in Wayfinder Family Services program is at my own risk.
AUTHORIZATION FOR TREATMENT / CONSENT, RELEASE, AND COVENANT * Required Medical Authorization:
In the event of a medical or dental need or emergency, every effort will be made to contact the participant or parent/guardian. If the participant or parent/guardian cannot be reached, I hereby authorize Wayfinder Family Services and its staff or officers to act as my agent (or the agent of the minor) to obtain and consent to any x-ray examination, anesthetic, medical, dental, surgical diagnosis, treatment, or hospital care deemed advisable by a licensed physician or dentist, whether such care is rendered at a medical office, hospital, or other licensed facility.
Financial Responsibility:
I understand and agree that any medical, dental, or hospital expenses incurred during participation are the responsibility of the participant if an adult, or the parent/guardian if the participant is a minor. Current medical insurance is required to participate in any program or event.
Release and Covenant:
I, on behalf of myself and/or my minor child, release Wayfinder Family Services, its officers, agents, and employees from any and all liability for accidents, injuries, or illnesses occurring during or related to participation in any program or event. I further agree not to institute any legal action against Wayfinder Family Services related to participation in its programs or activities.
Acknowledgment:
This authorization applies while the participant is enrolled in Wayfinder Family Services’ programs unless revoked in writing. I understand this form provides authority in advance of any specific medical situation and is given for the participant’s safety and well-being.
I, the undersigned participant, or, if applicable, the parent/guardian of the minor participant named below, wish for the participant to take part in the programs of Wayfinder Family Services and have read and agree to the AUTHORIZATION FOR TREATMENT OF ADULT CONSENT, RELEASE, AND COVENANT
AUTHORIZATION FOR TREATMENT / CONSENT, RELEASE, AND COVENANT * Required Medical Authorization:
In the event of a medical or dental need or emergency, every effort will be made to contact the participant or parent/guardian. If the participant or parent/guardian cannot be reached, I hereby authorize Wayfinder Family Services and its staff or officers to act as my agent (or the agent of the minor) to obtain and consent to any x-ray examination, anesthetic, medical, dental, surgical diagnosis, treatment, or hospital care deemed advisable by a licensed physician or dentist, whether such care is rendered at a medical office, hospital, or other licensed facility.
Financial Responsibility:
I understand and agree that any medical, dental, or hospital expenses incurred during participation are the responsibility of the participant if an adult, or the parent/guardian if the participant is a minor. Current medical insurance is required to participate in any program or event.
Release and Covenant:
I, on behalf of myself and/or my minor child, release Wayfinder Family Services, its officers, agents, and employees from any and all liability for accidents, injuries, or illnesses occurring during or related to participation in any program or event. I further agree not to institute any legal action against Wayfinder Family Services related to participation in its programs or activities.
Acknowledgment:
This authorization applies while the participant is enrolled in Wayfinder Family Services’ programs unless revoked in writing. I understand this form provides authority in advance of any specific medical situation and is given for the participant’s safety and well-being.
I, the undersigned participant, or, if applicable, the parent/guardian of the minor participant named below, wish for the participant to take part in the programs of Wayfinder Family Services and have read and agree to the AUTHORIZATION FOR TREATMENT OF ADULT CONSENT, RELEASE, AND COVENANT
MEDIA RELEASE * Required Permission is hereby given to WAYFINDER FAMILY SERVICES® to use audio, video recordings, photographic and electronically created images of the camper noted in this application for public view, including publications, websites or social media sites. Usage of any images or audio is without compensation to said person or to the undersigned on his/her behalf, or individuality.
I have read and agree to the MEDIA RELEASE
Special Event Waiver * Required In consideration of the acceptance of my family’s participation in the following activity listed on this form, I, the undersigned, intending to be legally bound, do hereby for myself and my family (including heirs, executors, administrators and assigns) forever waive, release and discharge any and all rights, claims and actions for damages that we may have, or that may hereafter accrue to us against WAYFINDER FAMILY SERVICES, including all of its officers, directors, members and volunteers.
I attest and verify that we are physically able to participate in this activity. We further understand that accidents and injuries can arise out of the event; knowing the risks, nevertheless, I hereby agree to ASSUME ALL RISKS OF PERSONAL INJURY, PERMANENT, TEMPORARY, TOTAL OR PARTIAL DISABILITLY, DISFIGUREMENT, PARALYSIS AND ANY OTHER LOSSES OR DAMAGE TO PERSON OR PROPERTY OR DEATH, sustained while participating in, attending, preparing for or traveling to and from the above described activity, including the risk of negligence of the WAYFINDER FAMILY SERVICES, or hidden, latent or obvious defects in the facilities or equipment used.
I have read this waiver and am in agreement with its contents.
Hold Harmless * Required In consideration of the acceptance of my family’s participation in the activity listed on this form, I, on behalf of myself and my family, agree if any claim for personal injury or wrongful death is commenced against WAYFINDER FAMILY SERVICES (including its officers, directors, members and/or volunteers), we will defend indemnify and hold harmless WAYFINDER FAMILY SERVICES, from any and all claims or causes of action for personal injuries, property damage or wrongful death that hereafter accrue, arise out of, result from, or are caused directly or indirectly by my family’s participation in this activity.
I have read the Hold Harmless Release and am in agreement with its contents.
Signature Confirmation * Required By entering my full name below, I confirm that I have read, understood, and agree to the terms outlined in the Waiver & Release of Liability above. I understand that typing my name serves as my digital signature and legally binds me to the terms of this agreement.