SOP Registration Child Release Form v1

I am the parent or legal guardian of the child participant named on this release form. I am familiar with the program for which I am registering the child.  I understand that this program involves activities of a physical nature that will take place in an outdoor environment and may include hiking on trails and rough terrain and in the vicinity of bodies of water, overnight stays and walking on high bridges and canopy walkways.  I further understand that there are risks associated with these kinds of activities.

 

Covid-19 Warning.  An inherent risk of exposure to Covid-19 exists in any area, public or private, where people are present together.  Covid-19 is an extremely contagious disease that has been known to lead to severe illness and to death.  In addition, there is evidence of asymptomatic cases of Covid-19 whereby individuals may transmit this disease unknowingly to other individuals.  By my child attending IslandWood, I voluntarily assume all risks to my child related to exposure to Covid.

 

As a condition of participation in this program and/or the use of IslandWood equipment and/or facilities, I agree that I will be fully responsible for any and all personal injuries, property damage, loss of personal property, or any other loss that may result from my child’s participation, and I agree not to hold IslandWood responsible, and their respective agents and employees, to the fullest extent permitted by law, for any damages, liabilities or expenses that result from participation in this program and/or the use by the participant of any IslandWood facilities and /or equipment.

 

If my child is taking any medication, I understand that IslandWood will not be responsible for administering or dispensing such medication, and that I will be required to make any necessary arrangements for the administering of such medication through the participant’s school.  I hereby give permission to personnel of ISLANDWOOD to authorize any x-rays, tests, procedures, anesthetic, surgery, or treatment on behalf of, and to provide or arrange for any transportation of, my child as may be required in the event of an emergency.  If I, or the emergency contacts designated previously, cannot be contacted, I hereby give permission to a licensed physician, or other qualified health care provider as may be appropriate, to administer such treatment to my child, the participant, as may be necessary under the circumstances, including the hospitalization of my child.

 

I certify that I have completed the Health History and Health Questionnaire on the back of this form fully and accurately and accept full responsibility for any errors or omissions.

 

MEDIA/ARTWORK AUTHORIZATION:  I agree that any photographs, video, digital images, or statements taken by IslandWood representatives of my child as a program participant, and copies of artwork made by my child while an IslandWood program participant, shall be the property of IslandWood, and may be used by IslandWood, at its discretion, for any publicity, education, marketing and/or advertising purposes and I hereby consent to and authorize such use without restriction. I acknowledge that I will not be owed any compensation, regardless of such use.

 

Registration for this program requires a parent or legal guardian to provide IslandWood with the appropriate personal information that might include age, school information, and dietary information. Only in combination with parental information, collected information may be used for sending out promotional materials and emails. In compliance with IslandWood’s Privacy Policy and the Children’s Online Privacy Protection Act of 1998 (COPPA), IslandWood will not use online collected information without verifiable parental consent. By signing this form, I consent to allow IslandWood to use my and my child’s collected information. Full details of IslandWood’s privacy policy can be found at: https://islandwood.org/privacy-policy. If I do not wish to receive any further correspondence, I understand I may contact info@islandwood.org to request I be unsubscribed from future communications.








































*Identifying information will not be shared with any outside person or organization


*Please take necessary precautions, such as notifying your child's teacher, submit any required paperwork, and provide the school with the necessary supply of your child's medication before the trip.

These are NOT food allergies (please list those in next question). An example of a food request / preference is: only eats plain pasta.

*We are able to accommodate most food requests if we have advance notice.

If you listed any food allergies, your child must have a School Health Plan on file at school OR you must submit a doctors’ Food Allergy Action Plan before your child may attend.  We are able to accommodate most food allergies with this advance paperwork.

Is there anything else that you believe is important for us to know in regards to the participant participating in this program? If so, please describe below.







MEDIA/ARTWORK AUTHORIZATION:  I agree that any photographs, video, digital images, or statements taken by IslandWood representatives of my child as a program participant, and copies of artwork made by my child while an IslandWood program participant, shall be the property of IslandWood, and may be used by IslandWood, at its discretion, for any publicity, education, marketing and/or advertising purposes and I hereby consent to and authorize such use without restriction. I acknowledge that I will not be owed any compensation, regardless of such use.

I CERTIFY THAT I HAVE CAREFULLY READ THIS AGREEMENT, FULLY UNDERSTAND IT, AND GRANT PERMISSION FOR MY CHILD TO PARTICIPATE IN THIS PROGRAM.



SIGNATURE AND DATE WILL BE REQUIRED AFTER CLICKING SUBMIT.

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