Reg From — GO Adventure Co.

PARENT/GUARDIAN INFO

If you have completed this section for another one of your GOers you can skip to "CAMPER INFO"

Your Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

CAMPER INFO

Name

First Name

Last Name

Birthdate

YYYY

Health Card Number

Does the participant take any medication: (oral, injection or inhaler) ?

Yes

Does the participant have any specific conditions, which may impact their participation in the program ?

Yes

Does the participant have any life- threatening allergies ?

Yes

If you answered YES to any of the above questions Please give specific details below.

EMERGENCY CONTACT INFO

Name - Contact #1

First Name

Last Name

Phone

(###)

###

####

Relationship

Name - Contact #2

First Name

Last Name

Phone

(###)

###

####

Relationship

If your child may be picked up by someone not listed above please let us know who they are.

PERMISSION AND WAIVER FORMS

Photo Release

I give GO Adventure Co. permission to take photographs of my child during program/camp activities. I am aware that these photos may be used for promotional purposes.

Yes

Sunscreen

I give GO Adventure Co. permission to use and apply sunscreen on my child during program/camp activities.

Yes

Emergency Response Agreement

In the event of an accident, injury or illness involving the participant, and immediate contact by staff with a designated contact cannot be made, I hereby authorize and grant permission to staff to secure proper medical treatment and authorize on the Registrant’s behalf all procedures, including, without limitation, admission to an emergency unit, hospital and treatment there in, ordering of x-rays, tests or treatment, injections, anesthesia and/or surgery, as deemed necessary by the attending medical professional(s). I agree not to hold Go Adventure Co. (2512541 Ontario Inc) responsible for any costs or injury arising out of an emergency situation.

Yes

Waiver Agreement

By completing this Release of Liability and Assumption of Risk agreement form you acknowledge that you are giving up certain legal rights and hereby represent and warrant to 2512541 Ontario Inc operating as Go Adventure Co.: (1) You are over the age of majority in your jurisdiction of residence. (2) You are registering for a Program as yourself or on behalf of a minor, in which case you acknowledge that you are his/her parent/legal guardian and as such are fully authorized and entitled to enter into this agreement on his/her behalf. While staff and instructors will make every reasonable effort to minimize exposure to known risks associated with activity, sport or program, I hereby acknowledge that I, and/or my child if I am registering on his/her behalf, may be required, depending on the nature of the Program, to participate in various physical activities that may involve risk of injury and I knowingly and freely assume all risks, both known and unknown regardless of how they arise and assume full responsibility for the Registrant’s participation. I understand that all rules for participation must be followed and at all times the sole responsibility for the Registrant’s personal safety is on them. In this regard, I agree that I have provided (if required) a complete and accurate health history and hereby permit the Registrant to participate in the full range of Program activities, except as specifically noted by me in the health information section of the Program registration (where applicable). In consideration for the Registrant’s opportunity to participate in the Program, the receipt and sufficiency of which is hereby acknowledged, I on behalf of my personal representatives and next of kin, hereby release and forever discharge 2512541 Ontario Inc operating as Go Adventure Co., its respective officers, directors, employees, volunteers and agents, and their respective successors and assigns, from any and all liability for damages sustained in consequence of loss, injury, disability or damage to the Registrant, and from all other actions, causes of action, claims, demands or damages of any kind with respect to death, injury, loss or damages to any person or property arising out of, or connected with preparation for, or participation in, the Program. I have read this Release of Liability and Assumption of Risk agreement, fully understand it’s terms, and by checking below acknowledge that I have signed it freely and voluntarily without any inducement.

I Agree

Cancellation and Registration Policy

Cancellation Policy If WE have to cancel: If we cannot run a week of camp due to unforeseen circumstances a full refund will be given to participants including the $50 deposit. These cancellations may be last minute and out of our control. If YOU have to cancel your child’s spot at a week of camp: If something comes up where the participant can no longer attend the camp/program they’ve signed up for, we’ll be bummed out they’re missing out, but we do have a refund policy. GO Adventure Co. must be contacted, by email or telephone: No later than 1 week before the start date of the camp/program for a full refund minus the $50 non refundable deposit. Notices under 1 week but no later than 72 hours before the start of the week (generally that means by 9am the Friday before) will receive a 50% refund No shows or cancellations without 72 hours notice will not be refunded. Registration Policy A $50 non refundable deposit is required at registration to ensure your spot in each week registered. This is to ensure that those who are registering are fully committed to their week(s) as camp space is very limited this summer.

I Agree

Camper Info

GO ADVENTURE CO.