Nature Explorers Camp

Student Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Phone *

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Alternate Emergency Phone #

(###)

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Waiver: I give my consent for above named student to participate in Bullington Garden’s Nature Explorers Camp. I agree and undertake to save and hold harmless Bullington Gardens, its employees, instructors, volunteers, officers and partners from any and all claims for damage to person and/or property that may result from activities conducted during the Nature Camp and acknowledge that there is always a certain amount of risk involved in any activity. I acknowledge that the above student is able to participate in physical activities associated with this camp. I further acknowledge that the above student must comply with the camp rules and regulations. Students who do not comply may be asked to withdraw with no refund of payment. *

Yes

No

I agree to allow my child to be photographed/videotaped for use of Bullington Gardens promotional or educational purposes. *

Yes

No