Youth Outdoor Field Day
REGISTRATION & RELEASE FROM LIABILITY FORM
The following form is to be completed by the parent or guardian of the youth (age 8-14) who will be participating in the Youth Outdoor Field Day held at Bowmanstown Rod and Gun Club, Palmerton. PA on Saturday, September 16, 2017. Please complete ONE form for EACH youth attending the event. – Thank You.
Youth’s: Name (Last, First): ____________________________________________
Age (as of event date):_______ Birth date: _____/_________ Number of people attending event: ____ (If registering more than one child, enter each child on their own form and additional attendees (parents, siblings, etc.) on only one child’s form.
T-shirt size (Men’s sizes only): Sm___ Med___ Lg ___ XL___ 2XL___ 3XL___Other____
Please group my child with: (optional) ____________________________________________________
Parent’s/Guardian’s: Name: _________________________________________
Phone #: (______) ______ – __________
Name of Parent or Guardian accompanying youth: _________________________________________
*** Each youth or family must be accompanied by an adult at all activities.
(Each youth may be accompanied by one or more adult including grandparents – siblings are welcome as spectators as well.)
I, ____________________, do hereby permit my child to participate in the various activities offered by the Youth Outdoor Field Day Organization on Saturday, September 16, 2017 at Bowmanstown Rod and Gun Club at his/her own risk. I understand that as a participant my child’s picture may be taken and used for the purposes of the Youth Outdoor Field Day Organization, including use on the Bowmanstown Rod and Gun Club website. In so consenting, the Youth Outdoor Field Day Organization, sponsors, and volunteers of the Youth Outdoor Field Day are released from any liability due to accident or injury during the day’s activities.
(Signature of Parent or Guardian)
MAIL THIS FORM TO: Youth Outdoor Field Day Registration, Bowmanstown Rod and Gun Club, 525 Club Road, Palmerton PA, 18071.
OR FAX THIS FORM : (610) 852-3441
OR E-MAIL THIS FORM TO: bowmanstownRGC@outlook.com
*** All information provided will be kept STRICTLY CONFIDENTIAL and will be used ONLY for the Bowmanstown Youth Outdoor Field Day Registration.***
Youth’s Registration #_______
(For Office Use Only