Winter Camp Registration Form

Humane Education

Winter Camp Registration Form

Please fill in the below form completely to apply for Winter Camp 2018.

Rescue Village’s annual Winter Camp is limited to 20 campers and is open only to children ages 9-11 years old. If you are more comfortable filling out and emailing or faxing a PDF version of this form, please click here.

Winter Camp 2018 is a 2-day camp that runs December 27th and December 28th from 10:00 AM – 1:00 PM.

The fee for Winter Camp per camper is $100 total due at the time of registration.

If there are any questions or concerns about Winter Camp or for additional information, please contact Nicole Latosky at (440) 338-3819 ext. 20 or education@rescuevillage.org.

  • Date Format: MM slash DD slash YYYY
  • Payment Information

    Payment of $100 total is due at the time of registration. We will manually process your credit card information below as soon as we receive this form.
  • Waiver of Liability and Permission Form

    In consideration of my child’s participation in Winter Kids Camp and other activities, the undersigned as parent/legal guardian of the minor identified below hereby agrees to hold harmless, release, waive, forever discharge and covenant not to sue the Geauga Humane Society (hereby hereafter referred to as GHS), its administrators, directors, agents, servants and employees, all of which are hereinafter referred to as “Releasees” from any and all liability to my child and myself along with our heirs, assigns and next of kin for any and all claims demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise.It is further agreed that the undersigned is fully aware of the nature and extent of the potential hazards and risks of children working with and /or near shelter animals and/or experiences that may arise, and agrees to assume those risks and to release, discharge, indemnify and hold harmless all of the Releasees mentioned above who (through negligence, carelessness or otherwise) might be liable to my child, myself or my heirs or assigns for damages. The undersigned releases, waives, forever discharges and covenants not to sue the Releasees for any and all loss or damage to personal property that may occur while participating in the GHS Winter Kids Camp.The undersigned hereby grants permission to the GHS to use any photographs or video taken of the below-named minor, or artwork created by such minor, for use in its public relations efforts. The GHS has permission to include the minor’s name in materials that promote or publicize GHS services, programs and events, without compensation or notification. The undersigned understands that the minor will be participating in activities that may include media coverage, including, but not limited to, television, radio and newspaper.The undersigned hereby grants permission to the GHS to utilize and authorize any medical emergency services it deems necessary for the below-named minor.
  • By filling in the name of the legal guardian of the minor participating in Winter Camp, you have read and understand the above waiver of liability and permission form.