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Camp Happy Tails Register

$
Sessions

Session

Pick as many days as you like. All sessions run from 9am—3pm

Cost & Payment

# of sessions × $50 + # of Extended days x $15 per day = Total

Basic Info
Contact Information

Please list anyone who is authorized to pick up your child from camp, including carpool drivers and anyone who would pick up in an emergency. Driver’s licenses will always be checked upon camper pick up.

Parent Name Phone Number Actions
Medical Information
Emergency Contact

Acknowledgment and Assumption of Risks

In consideration of the services of the Potter League for Animals, its agents, owners, employees, representatives, and all other entities associated with it (hereafter collectively referred to as PLA), I agree as follows: I, the undersigned, have enrolled my child in Camp offered by PLA. I understand that participation in PLA Camp involves activities that include interactions with animals. I understand that PLA does not know the complete history of all the animals at PLA and I further un- derstand that the animals’ behavior may be unpredictable. I release and discharge PLA from any and all responsibility for any injuries that my child may receive as a result of being at PLA, including, but not limited to, bites and scratches. On behalf of my child, I hereby release, discharge, indemnify and hold harmless PLA from any and all claims present and future and rights to compensation that may arise from or relate to (1) any act or omission of PLA parties (other than intentional misconduct) and (2) any damage, loss, illness, injury or death (including animal bites and scratches) sustained by my child during, in connection with or arising from, my child’s participation in the PLA Camp. I intentionally and knowingly waive any and all such claims that I may have against such persons and I reserve only and do not waive or release claims for intentional misconduct. This release will be binding and enforceable against me, my child and our personal representatives, successors and assigns with respect to my child’s participation in the PLA Camp. I am the parent or legal guardian of the participant named above. I am of legal age and am freely signing this agreement of behalf of the participant. I hereby certify that I have read, consent and agree to the foregoing waiver of liability authorization and consent and sign it voluntarily.

Personal Info

Credit Card Info
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Billing Details

Donation Total: $50.00