2025 Summer Camp Registration

First name

Last name

Child's Name

Phone

Address

Child's Birthday

Month

Day

Year

Sessions (please select at least one)

July 14 - July 18 (daily 4-9 y.o.)

July 24 - July 25 (overnight 10-12 y.o.)

Emergency Contact 1 (Full name and number)

Emergency Contact 2 (Full name and number)

Insurance Information (front and back of insurance card)

Has the individual been immunized?

Yes

Are there any health issues we should be aware of? If yes, please explain. (Health form required if participant indicates yes to any health/medication/allergy issues, see Health Forms.)

My child has permission to be transported by WildLife Nature Experience to local parks and recreational areas. Important Note: Days run from 9:30AM and 2:30PM for those providing their own transportation to and from the location of the day.

Yes

My child can swim and has permission to participate in swimming and wading activities. I understand that the children will be supervised at all times by WildLife Nature Experience. Only waters meeting applicable local standards will be used.

Yes

Wading ONLY

My child has permission to reapply insect repellent or sunscreen every two hours or as needed. WildLife Nature Experience, WNE, may assist my child if needed. In the event that sunscreen or insect repellent is forgotten, I give WNE permission to apply.

Yes

WildLife Nature Experience may take and use my child's photo for personal and/or professional purposes.

Yes

As a parent/legal guardian, I give consent to have my child receive first aid by WildLife Nature Experience, and, if necessary, be transported to receive emergency care. I understand that I will be responsible for all charges not covered by insurance.

Yes

The cost for our programs vary based on the dates selected. Additional fees for bounced checks are $50.00. By clicking yes, you are agreeing to pay all program cost and any fees in full before attending. Payments are nonrefundable.

Yes

We reserve the right to cancel a program or change a program duration, cost, or location. There are no make-ups. Failure by WildLife Nature Experience, WNE, to enforce one or more of the terms does not waive the right of WNE to enforce any other terms.

Yes

By clicking yes it indicates that I/we agree to abide by the terms of WildLife Nature Experience. WildLife Nature Experience may change the terms from time to time, notification will be given of any changes.

Yes

By signing this form, I, the undersigned, do hereby voluntarily participate and/or have a child/children in WildLife Nature Experience, WNE, (Saplings Preschool, LLC) outdoor immersion programs. I do hereby assume full responsibility for any and all damages, injuries or losses that I or my child/children may sustain or incur, in any event or activity while participating in WildLife Nature Experience, WNE, (Sapling Preschool, LLC). I do hereby waive all claims against state and local parks, recreational areas, WildLife Nature Experience, Saplings Preschool, LLC, Amanda Stubbs, Ashley Stubbs, WNE staff members, and other participants for any claim for injury, losses, or damages that I or my child/children may sustain. I have read and understand this liability waiver and understand its terms. I execute it voluntarily and with full knowledge of its significance.

Signature

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