Registration Form Space is Extremely Limited, so register early! Please Register my Child for Cat Camp for Kids! Check Desired Week [] Week 1 []Week 2 []Week 3 [] Week 4 []Week 5 _________________________________________________ Child’s Name Registration Deadline is June 12, 2015 ___________________________________________________________________________________ Date of Birth ___________________________________________________________________________________ Address ___________________________________________________________________________________ City State Zip ___________________________________________________________________________________ Please Note: There is a $25 cancellation fee. Parent’s Name ___________________________________________________________________________________ Daytime Phone Number ___________________________________________________________________________________ Any Questions? Email Address In Case of Emergency, Please Call: ___________________________________________________________________________________ Name ___________________________________________________________________________________ Phone Number Contact Ryan Inama, Development Assistant at [email protected] or Emma Crawford, Marketing Specialist at [email protected] Is there anything special we should know about your child? (allergies, health restrictions, etc.?) ___________________________________________________________________________________ You can also call 520.571.7839 ___________________________________________________________________________________ Please Charge My: [] Visa [] MC The Hermitage No-Kill Cat Shelter [] Discover ___________________________________________________________________________________ Card Number Exp. Date ___________________________________________________________________________________ Signature 5278 E 21st Street Tucson, AZ 85711 [email protected] Cat Camp For Kids! Kitten Camps for children aged 6-9 years Moggie Camps for children aged 10-12 years Cat Camp for Kids Program & Schedule Cat Camp Activities Cost: $200 per child, for ages 6-12 Meet & Socialize the Cats Visit With Shelter Staffers Camp Schedule Monday to Friday, 10am to 4pm Learn Animal Kindness Get a Humane Education Learn about & Play With Cats Week 1: June 22-26, for 6-9 years old June 29-July 3: No Camp due to 4th of July holiday Meet Other Kids Who Love Cats Week 2: July 6-10, for 10-12 years old Arts & Crafts Week 3: July 13-17, for 6-9 years old And Much More... Week 4: July 20-24, for 10-12 years old Week 5: July 27-31 for 6-9 years old Release, Consent & Indemnification The undersigned parent/guardian of ______________________________________ (“Minor”) hereby consents to the Minor participation in the Cat Camp for Kids of The Hermitage No-Kill Cat Shelter, Tucson, Arizona, and all of its activities and programs and in consideration thereof provides the Release, Consent and Indemnification. The Undersigned, for himself or herself and on behalf of said Minor, does hereby absolutely and unconditionally release, indemnify, hold harmless, and forever discharge The Hermitage No-Kill Cat Shelter, its employees, successors, assigns and agents and each of them, for and against all claims, demands, obligation and liabilities of every kind and nature whatsoever, including, without limitation, negligence, including the negligence of The Hermitage No-Kill Cat Shelter and its Agents, occurring during, directly or indirectly resulting from or arising out of the Minor’s participation in such Cat Camp for Kids. As to matters covered hereby, the Release, Consent and Indemnification shall pertain to all claims, demands and rights which the undersigned Minor and/or each other heirs, successors, and assigns has or may ever have against the parties released and indemnification hereby, or any other them, for any injuries, costs or damages to the Minor occurring directly or indirectly resulting from or arising out of the Minor’s participation in such Cat Camp for Kids whether such injuries, costs or damages are known, unknown, foreseen or unforeseen, ascertainable or unascertainable or suffered by participant or any other person. _____________________________________________ Parent/Guardian Signature and Date You May use photos, slides, or videos of my child in public service, promotional, educational or internet materials for The Hermitage No-Kill Cat Shelter ________________________________________________________ Parent/Guardian Signature and Date You May Not use photos, slides or videos of my child in public service, promotional, educational or internet materials for The Hermitage No-Kill Cat Shelter ________________________________________________________ Parent/Guardian Signature and Date Please Note: The Hermitage No-Kill Cat Shelter is not a licensed day care facility, and as such, children can leave of their own volition.
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