Nature Ranger Camp Registration

Kids & Nature.jpg
 
 
 
Child's Name *
Child's Name
Child's Date of Birth *
Child's Date of Birth
Parent/Gaurdian Name *
Parent/Gaurdian Name
Mailing Address *
Mailing Address
Primary Phone *
Primary Phone
Alternate Phone
Alternate Phone
Emergency Contact (in the event we can't reach parent/guardian listed on this form) *
Emergency Contact (in the event we can't reach parent/guardian listed on this form)
Child's Primary Care Provider
Child's Primary Care Provider
I give permission for Oceana Conservation District to use photographs of my child during programming for promotional purposes
I release Oceana Conservation District from liability in case of accident during activities when proper stafety procedures have been taken *