Home
Register Here
About
Contact
Daily Activities and Lunch
What to Bring
Location, Parking & Drop off
Volunteers
Frequently Asked Questions
Home
Register Here
About
Contact
Daily Activities and Lunch
What to Bring
Location, Parking & Drop off
Volunteers
Frequently Asked Questions
Willi Wise Day Camp Adult Registration
Adult Leader Info
*
Indicates required field
Leader's Name
*
First
Last
Gender
*
Male
Female
Birthdate
*
Age
*
Phone Number
*
Alternate Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Do you have a child attending camp?
*
Yes
No
Driver's License or State Issued ID Number
*
If yes, childs name(s)
*
Do you grant Willi Wise Day Camp to perform a background check on you:
*
Yes
No
Have you ever been charged with or convicted of a misdemeanor or felony?
*
Yes
No
If yes - Please give a detailed explanation.
*
Have you been to Willi Wise before?
*
Yes
No
T-Shirt Size
*
YS
YM
AS
AM
AL
AXL
XXL
Age or Grade Level you would like to lead:
*
Health History
Name of Family Physician
*
Phone Number
*
Medical Insurance Carrier
*
Policy / Group Number
*
Please list any known allergies or health conditions:
*
Please list and activities that should be restricted:
*
Please list a
local person who may be contacted in case of emergency.
Name
*
First
Last
Relationship to Leader
*
Phone Number
*
Alternate Phone Number
*
This health history is complete & accurate to the best of my knowledge. I know of no reason other than the information indicated on this form why my child should not participate in Willi Wise Day Camp activities.
*
Yes
No
RELEASE WAIVER HOLD HARMLESS AGREEMENT
Land-O-Lakes Bowmen
Release, Waiver and Hold Harmless Agreement:
Whereas, in return for use of premises, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged by the undersigned, the undersigned agrees to hold Land O Lakes Bowmen {LOL} and their agents harmless for any and all fault, liability, cost, or expenses for any and all claims arising out of related to or connected with the use of the LOL premises and the undersigned presence theron, and acknowledge risk of discharging bows. Should any claim, demand, of lawsuit as described above arise or be asserted.
I the undersigned will hold LOL harmless from any and all cost of any settlement or, judgment made or rendered against LOL whether individually, Jointly, or in solid with the undersigned, together with all costs of court and other costs or expenses incurred in connection with any such claim, demand or lawsuit, including reasonable attorney fees.
The undersigned further waives for themselves and their parents, guardians, executors, administrators, assignees, designees, heirs, or legatees, any and all rights and claims for damages, losses, demands and any other actions whatsoever, which they may have of which may arise against LOL and it’s agents related to the use of LOL’s premises and the undersigned presence Theron or the use thereof, and the assumed risk of the discharge of a bow including but not limited to any and all injuries or illness suffered by the undersigned.
This instrument binds the undersigned and their parents, guardians, executors, administrators, assignees, designees, heirs, or legatees.
Leader's Name
*
First
Last
Digital Signature
*
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