Parent/Guardian Name (#1) *

First Name

Last Name

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Name (#2)

First Name

Last Name

Phone

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Camper #1 Name *

First Name

Last Name

Camper #1 Birthdate *

MM

DD

YYYY

Name

First Name

Last Name

Date

MM

DD

YYYY

Emergency Contact #1 *

First Name

Last Name

Phone *

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Emergency Contact #2 *

First Name

Last Name

Phone

(###)

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Primary Care Doctor

First Name

Last Name

Phone

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Waiver of Liability *

I, as parent/guardian of child/children listed above, hereby assume all risks and hazards incidental to the conduct of the activities at Sang Lee Farms,inc. and transportation to and from the activities. My Child is fit for the program(s) in which I have enrolled him/her. I HEREBY RELEASE AND SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS RELEASES FROM EVERY CLAIM AND ANY LIABILITY THAT I OR MY CHILD MAY ALLEGE AGAINST RELEASEES (including reasonable legal fees and costs) AS A DIRECT OR INDIRECT RESULT OF INJURY OR DEATH TO ME OR MY CHILD BECAUSE OF MY CHILD’S PARTITIPATION IN ANY Sang Lee Farms,inc. PROGRAMS , WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERS TO THE MAXIMUM EXTENT PERMITTED BY LAW. I PROMISE NOT TO SUE RELEASEES ON MY BEHALF OR ON BEHALF OF MY CHILD REGARDING ANY CLAIM ARISING FROM OR RELATED TO MY CHILD’S PARTICIPATION IN ANY Sang Lee Farms,inc. PROGRAM(S). I ACKNOWLEDGE THAT, BY SIGNING THIS DOCUMENT, I AM RELEASING Sang Lee Farms,inc., AND THEIR REPRESENTATIVES, AGENTS, EMPLOYEES, VOLUNTEERS, MEMBERS, SPONSORS, PROMOTERS, AND AFFILIATES (COLLECTIVELY “RELEASEES”) FROM LIABILITY, AND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS SIGN UP AND RELEASE FORM IS A CONTRACT WITH LEGAL AND BINDING CONSEQUENCES AND IT APPLIES TO ALL ACTIVITIES IN WHICH MY CHILD ENGAGES DURING THE SUMMER CAMP AT Sang Lee Farms,inc. , REGARDLESS OF WHETHER SUCH ACTIVITY IS A PART OF A FORMAL PROGRAM. I HAVE READ THIS RELEASE CAREFULLY BEFORE SIGNING. I UNDERSTAND WHAT THIS RELEASE MEANS AND WHAT I AM AGREEING TO BY SIGNING.

I agreen and understand the above waitver and by checking this box I am agreeing to all that it contains.

Name *

By typing my name I am signing in agreement

First Name

Last Name

Photo Waiver *

By signing this form, I, as parent/guardian, permit Sang Lee Farms, Inc to use pictures of my child(ren) as a program participant in promotional literature, videos, and the Sang Lee Farms, Inc website. I understand my child(ren)’s name(s) will not be published.

I understand and agree.

I do not want my child's picture used where you can see their face.

Name *

First Name

Last Name

Phone

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