Forms - Summer 2024

Permission and Waiver Form

Apply now online or submit electronically to dianne@campakomak.com OR print registration form; complete clearly; scan and send to business office.

This form must be signed prior to the start of camp

Only one per family if travel details are the same.
CAMPER INFORMATION
Camper Name*
First name Last name
Session*
E-mail*
PERMISSION AND WAIVER
Consent*
Yes, I agree to the terms
On behalf of my child, I understand that my child’s participation in Camp Ak-O-Mak for Girls program is completely voluntary.
- I have familiarized myself with Camp Ak-O-Mak’s program and activities.
- I give permission for my child to participate in any activities on the camp premises and any trips out of camp during the summer.
- Although Camp Ak-O-Mak takes reasonable safety measures to minimize the risk of injury, I recognize that certain risks are imminent in the camping industry. I therefore release Camp Ak-O-Mak from and waive any claim for injuries, loss, or other damages while on or off camp property during my child’s stay at camp.
- I further recognize and have instructed my child in the importance of knowing and abiding by Camp Ak-O-Mak’s rules, regulations and procedures for the safety of participants.
- I also give permission for my daughter’s likeness to be used in camp promotional materials such as, but limited to, Camp brochure, website, video, social media posts.
- I also agree and accept to pay any and all damages should my child participate in vandalism.
- I agree and accept that the proper forum for ANY legal action against Camp Ak-O-Mak or it’s associated personnel, including Medical, is the Province of Ontario, Dominion of Canada.
- I understand/accept that Store Purchases, Out of Camp Events with Food Purchases & Travel, additional Medical Expenses will be charged to my daughters Refundable Expense Account. Balance of refundable expense account to be charged to credit card on file.
- I understand and accept Camp Ak-O-Mak will be contacting by email.
Participant’s name (first child)
Participant’s name (second child)
Participant’s name (third child)
Participant’s Parent/Guardian*
Date*
(day / month / year)
Comments
This field is for validation purposes and should be left unchanged.

Forms - Summer 2024

Permission and Waiver Form

CAMPER INFORMATION

PERMISSION AND WAIVER

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