Parent/Guardian Information:

Registration Date: 2024-05-16 11:55 AM

First Name

Last Name

Parent/Guardian will also attend? (Check for Yes)

Phone

Address

City

State

Zip

How did you hear about this event?

Child Attendee Information:

Guest 1 Name Relationship

Age Physician Name/Phone

Dietary Restrictions Allergies

Health Conditions Additional Details

Guest 2 Name Relationship

Age Physician Name/Phone

Dietary Restrictions Allergies

Health Conditions Additional Details

Guest 3 Name Relationship

Age Physician Name/Phone

Dietary Restrictions Allergies

Health Conditions Additional Details

Guest 4 Name Relationship

Age Physician Name/Phone

Dietary Restrictions Allergies

Health Conditions Additional Details

Statement of Understanding/Disclaimer: (Check to accept)

To the fullest extent permitted by applicable law, I will hold harmless and indemnify the McFaddin-Ward House, its agents and employees, against any and all claims and actions arising out of my attendees' participation in our events and activities, including, without limitation, expenses, judgments, fines, settlements and other amounts actually and reasonably incurred in connection with any liability, suit, action, loss, or damage arising or resulting from my attendees' participation in registered events.

Medical Care Release: (Check to accept)

In case of emergency, I authorize the McFaddin-Ward House Museum staff to obtain emergency medical care for my attendees as needed.

Please provide name and phone for two emergency contacts

Photo Release: (Check to accept)

I authorize the McFaddin-Ward House staff and agents permission to photograph and video my attendees while attending our events for the explicit purpose of creating future marketing, archives and social media use.

Signature/Authorization (REQUIRED):

SIGN in the area below and click ACCEPT to store your signature or CLEAR to re-sign. (Mobile Users tap-and-hold to sign.)

Ranching Round-Up Summer Camp 2024

$45

Parent/Guardian Information:

Child Attendee Information: