Waiver Form - Under Blue Waters

Waiver of Liability

Ready For Excitment, Fun and Adventure?

Must Complete Waiver Before Attending Program

Participants Name *

Primary Parent/Guardian *

First

Last

Email *

Phone Number *

Secondary Number (Work, Cell, Home)

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Secondary Parent/Guardian *

First

Last

Email *

Phone Number *

Secondary Number (Work, Cell, Home)

Address

Address Line 1

Address Line 2

City

State

Zip Code

How Many Children in Family *

Child/ Camper Information

Name *

First

Last

Age *

DOB *

Allergies, Medical, Medications *

Tell us something interesting, amazing, fun,helpful about your child. *

Cancellation Policy: If for any reason participants need to cancel their reservation, Under Blue Waters will provide a credit to be redeemed on future purchases, less a $15 administrative fee. *

UBW Family Membership includes 1 waived cancellation fee.

MAKE UP POLICY: If for any reason participants need to reschedule their reservation, participants are subject to a $15 administrative fee *

UBW Family Membership includes 1 waived rescheduling fee per participant listed on UBW Family Profile.

CODE OF CONDUCT: The staff of UBW are committed to providing a safe and enjoyable experience for your child; however, campers are also responsible to assist in these efforts. Parents are responsible to make sure their child brings the appropriate clothing and items to camp. YOU MUST REVIEW THIS CODE OF CONDUCT. BEHAVIOR: 1. Campers must accept and get along with others. Put-downs, bullying, foul language, malicious teasing, practical jokes, etc., will not be tolerated from any camper. 2. Campers will be sensitive to others in terms of race, religion, physical characteristics, regional differences and language. Ethnic or religious slurs or jokes will not be tolerated. 3. Campers must respect others and their property. 4. Campers must follow directions the first time they are given. Most of our directions are for the safety of our campers. 5. Under Blue Waters is a tobacco, alcohol and drug free camp. Use and/or possession of tobacco, alcohol, drugs and/or any other substance defined as a drug or potentially dangerous are grounds for automatic dismissal. SAFETY: 6. Campers must wear shoes/sandals at all times. 7. Campers must pay attention to their surroundings and use care in all activities. 8. Campers must adhere to all safety rules and regulations given for each activity. GENERAL: 9. Campers must inform staff if they are experiencing a problem with another camper or other issue. If we are not informed about a problem, we cannot stop the problem or assist the camper. If a problem arises between a camper and a particular staff member, the camper needs to seek assistance from another staff member or camp director. 10. Violation of the CODE OF CONDUCT is grounds for automatic dismissal. Refunds are not given when a camper is dismissed for violations of Camper’s Code of Conduct. *

I have read the above CAMPER’S CODE OF CONDUCT. I agree to adhere to all of the above to ensure that my camp experience as well as that of other campers in attendance at the UBW camp is a positive one. I understand that failure to adhere to these rules may result in my dismissal from the program and camp fees will not be refunded.

Checkboxes *

I understand and certify that my child’s participation in UBW camp and its activities is completely voluntary and I have familiarized myself with the camp’s programs and activities in which my child will be participating. I recognize that certain hazards and dangers are inherent in the camp’s events and programs, and I acknowledge that although the camp has taken safety measures to minimize the risk of injury to camp participants, the camp cannot ensure or guarantee that the participants, equipment, premises and/or activities will be free of hazards, accidents and/or injuries. I further recognize and have instructed my child in the importance of knowing and abiding by the camp’s CODE OF CONDUCT for the safety of all camp participants.

RELEASE AND WAIVER OF LIABILITY/IMPLIED CONSENT: In signing this form, I understand that I waive the right to sue Under Blue Waters LLC, Maya Booth or any groups or individuals associated with Under Blue Water LLCs, for myself and my heirs, assigns or personal representatives. I am aware that Under Blue Waters LLC arrange activities involving marine science, experiments, hands on activities, outdoor learning, swimming, snorkeling, SCUBA diving, sailing, fishing and kayaking in the pool and/or ocean, and traveling by boat. In participating or allowing my child to participate in these activities, I acknowledge that during these activities, I or he/she may be exposed to certain risks which are inherent in the activity and cannot be eliminated without destroying the purpose and character of the activity, such as travel by boat, swimming in or near the pool and/or ocean, snorkeling in the ocean, accident or illness in remote places without immediate access to medical facilities, and/or the forces of nature, including sun, wind, and rain. I understand the description of these risks are not complete and that these and other unknown or unanticipated inherent risks my result in injury or death. In consideration for the right for myself or my child to participate in such activities, and other services and activities arranged for me or him/her, I have and do hereby assume all risks and will forever indemnify, hold harmless, and covenant not to sue Under Blue Waters LLC, its employees, property owners, directors, officers, and members from any and all liabilities, actions, causes of actions, debts, claims, demands, or other liability of every kind and nature whatsoever which may arise or in connection with my or his/her trip to or participation in *

CONFIRMATION: Payment, Registration Forms including Code of Conduct and Waiver of Liability Form MUST be complete to secure your campers spot. Since Camper availability is limited, complete packet as soon as possible to secure campers spot.

Checkboxes *

WHAT TO BRING AND ATTIRE: Please make sure your child is properly dressed for their day. This means having an Under Blue Waters, rashguard, bathing suit, towel, dry change of clothes, 3 closed non-refillable water bottles, sunscreen, shoes, and any personal items needed.

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ALCOHOL & SMOKING: Smoking and alcoholic drinks are NOT allowed at any of our events. This includes any guardians attending, picking or dropping off campers.

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SAFETY: Our instructors are trained lifeguards and if they give instruction it is imperative that both parents and children follow their guidelines.

Checkboxes *

PHOTOS/VIDEOS: Under Blue Waters will take pictures and video for marketing purposes that remain property of Under Blue Waters.

Signature *

Waiver of Liability

Ready For Excitment, Fun and Adventure?

Must Complete Waiver Before Attending Program

Child/ Camper Information

Second Child/ Camper Information

Third Child/ Camper Information

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