Common use of In case of Illness Clause in Contracts

In case of Illness. If a child is exhibiting any signs of illness, upset stomach, a cough or elevated temperature, the child cannot attend camp for that day. In the event that a child is unable to return to complete the camp there will be no refunds. I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me. Parent/Guardian name (print): Parent/Guardian signature: Date: Please note: CAP is not a licensed child care facility and is exempt from regulations from the TX Dept. of Family and Protective Services. Emergency Contacts & Authorized Transportation If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact? #1 Emergency Contact Person Name (NOT PARENT): Relationship: Daytime / Cell phone #: Please list anyone (other than parents/guardians) who is authorized to pick up your child from camp: I, hereby authorize that Citizens for Animal Protection can release my child to parent/guardian’s full name the following person(s). Name: DL State & # Phone#: (If anyone other than those listed above is to pick up my child, I need to notify CAP Kids & Kritters Camp staff at drop-off. Drop-Off / Pick-Up Arrangements CAP Kids & Kritters Winter Break Day-Camp Hours are 9 a.m. – 1pm. (CAP does not offer extended childcare options at this time.) Children can begin to arrive at CAP Kids & Kritters Camps no earlier than 8:45 a.m. All campers must be dropped off at side gate located on west side of the CAP Animal Shelter and signed in with the Kids & Kritters Camp staff. Please do not drive up and let your child/children walk into the facility alone. Campers will be ready to be picked up at side gate located on the west side of the CAP Animal Shelter at noon. each day. Campers will be released only to those persons whom the parent or guardian has designated on the program registration form. These persons may be asked to show proper identification at the time of pick-up. If you are late picking up your child, a late fee of $1.00 per minute beginning at 1:10 p.m. will be charged and due at the time you pick up your child. Your child/children need to be signed in and out by the parent/guardian or the persons who have been designated on this registration form. Waiver of Liability, Permission Form, and Release of Images ● I am the legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I understand that all participants including myself are expected to abide by all rules and guidelines established by Citizens for Animal Protection (CAP) during the camp. ● I understand that my child will be participating in activities at Citizens for Animal Protection (CAP) and that in the course of such activities the child will have direct contact with various animals such as walking dogs and feeding cats and rabbits. ● I further understand that while all precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing the risks of interacting with animals, on behalf of my child and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any of its officers, directors, employees, agents, or contractors for any and all personal injury or property damages resulting from my child’s participation in camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities. ● I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP. ● I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use. Parent/Guardian name (print): Parent/Guardian signature: Date: Payment Information ⭘ I have enclosed a check for $ per child per day camp. (Please make checks payable to Citizens for Animal Protection or CAP.) □ Please charge my credit card ⭘ Visa ⭘ MasterCard ⭘ AmEx ⭘ Discover Cardholder Name: Account #: Exp. Date: Signature: Date: Please note reservations for campers will not be held without full payment. Print, complete and submit application via email to xxx0xxxx@xxx0xxxx.xxx or drop off at the CAP Shelter. Thank you!

In case of Illness. If a child is exhibiting any signs of illness, upset stomach, a cough or elevated temperature, the child cannot attend camp for that day. In the event that a child is unable to return to complete the camp there will be no refunds. I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me. Parent/Guardian name (print): Parent/Guardian signature: Date: Please note: CAP is not a licensed child care facility and is exempt from regulations from the TX Dept. of Family and Protective Services. Emergency Contacts & Authorized Transportation If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact? #1 Emergency Contact Person Name (NOT PARENT): Relationship: Daytime / Cell phone #: Please list anyone (other than parents/guardians) who is authorized to pick up your child from camp: I, hereby authorize that Citizens for Animal Protection can release my child to parent/guardian’s full name the following person(s). Name: DL State & # Phone#: (If anyone other than those listed above is to pick up my child, I need to notify CAP Kids & Kritters Camp staff at drop-off. Drop-Off / Pick-Up Arrangements CAP Kids & Kritters Winter Break Day-Camp Hours are 9 a.m. – 1pm. (CAP does not offer extended childcare options at this time.) Children can begin to arrive at CAP Kids & Kritters Camps no earlier than 8:45 a.m. All campers must be dropped off at side gate located on west side of the CAP Animal Shelter and signed in with the Kids & Kritters Camp staff. Please do not drive up and let your child/children walk into the facility alone. Campers will be ready to be picked up at side gate located on the west side of the CAP Animal Shelter at noon. each day. Campers will be released only to those persons whom the parent or guardian has designated on the program registration form. These persons may be asked to show proper identification at the time of pick-up. If you are late picking up your child, a late fee of $1.00 per minute beginning at 1:10 p.m. will be charged and due at the time you pick up your child. Your child/children need to be signed in and out by the parent/guardian or the persons who have been designated on this registration form. Waiver of Liability, Permission Form, and Release of Images ● I am the legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I understand that all participants including myself are expected to abide by all rules and guidelines established by Citizens for Animal Protection (CAP) during the camp. ● I understand that my child will be participating in activities at Citizens for Animal Protection (CAP) and that in the course of such activities the child will have direct contact with various animals such as walking dogs and feeding cats and rabbits. ● I further understand that while all precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing the risks of interacting with animals, on behalf of my child and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any of its officers, directors, employees, agents, or contractors for any and all personal injury or property damages resulting from my child’s participation in camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities. ● I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP. ● I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use. Parent/Guardian name (print): Parent/Guardian signature: Date: Payment Information ⭘ O I have enclosed a check for $ per child per day camp. (Please make checks payable to Citizens for Animal Protection or CAP.) □ Please charge my credit card ⭘ O Visa ⭘ O MasterCard ⭘ O AmEx ⭘ O Discover Cardholder Name: Account #: Exp. Date: Signature: Date: Please note reservations for campers will not be held without full payment. Print, complete and submit application via email to xxx0xxxx@xxx0xxxx.xxx or drop off at the CAP Shelter. Thank you!

In case of Illness. If a child is exhibiting any signs of illnessill ness, upset stomach, a cough or elevated temperature, the child cannot attend camp for that day. In the event that a child is in unable to return to complete the camp there will be no refunds. I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me. Parent/Guardian name (print): Parent/Guardian signature: Date: Please note: CAP is not a licensed child care facility and is exempt from regulations from the TX Dept. of Family and Protective Services. Emergency Contacts & Authorized Transportation If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact? #1 Emergency Contact Person Name (NOT PARENT): Relationship: Daytime / Cell phone #: Please list anyone (other than parents/guardians) who is authorized to pick up your child from camp: I, hereby authorize that Citizens for Animal Protection can release my child to parent/guardian’s full name the following person(s). Name: DL State & # Phone#: (If anyone other than those listed above is to pick up my child, I need to notify CAP Kids & Kritters Camp staff at drop-off. Drop-Off / Pick-Up Arrangements CAP Kids & Kritters Winter Break Day-Camp Hours are 9 8 a.m. – 1pmnoon. (CAP does not offer extended childcare options at this time.) Children can begin to arrive at CAP Kids & Kritters Camps no earlier than 8:45 7:45 a.m. All campers must be dropped off at side gate located on west side of the CAP Animal Shelter and signed in with the Kids & Kritters Camp staff. Please do not drive up and let your child/children walk into the facility alone. Campers will be ready to be picked up at side gate located on the west side of the CAP Animal Shelter at noon. each day. Campers will be released only to those persons whom the parent or guardian has designated on the program registration form. These persons may be asked to show proper identification at the time of pick-up. If you are late picking up your child, a late fee of $1.00 per minute beginning at 1:10 12:10 p.m. will be charged and due at the time you pick up your child. Your child/children need to be signed in and out by the parent/guardian or the persons who have been designated on this registration form. Waiver of LiabilityLiability , Permission Form, and Form Release of Images ● • I am the legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I understand that all participants including myself are expected to abide by all rules and guidelines established by Citizens for Animal Protection (CAP) during the camp. ● • I understand that my child will be participating in activities at Citizens for Animal Protection (CAP) and that in the course of such activities the child will have direct contact with various animals such as walking dogs and feeding cats and rabbits. ● • I further understand that while all precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing the risks of interacting with animals, on behalf of my child and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any of its officers, directors, employees, agents, or contractors for any and all personal injury or property damages resulting from my child’s participation in camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities. ● • I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP. ● • I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use. Parent/Guardian name (print): Parent/Guardian signature: Date: Payment Information ⭘ 🞏 I have enclosed a check for $ $50.00 per child per day camp. (Please make checks payable to Citizens for Animal Protection or CAP.) □ 🞏 Please charge my credit card ⭘ 🞏 Visa ⭘ 🞏 MasterCard ⭘ 🞏 AmEx ⭘ 🞏 Discover Cardholder Name: Account #: Exp. Date: Signature: Date: Please note reservations for campers will not be held without with out full payment. Print, complete and submit application via email to xxx0xxxx@xxx0xxxx.xxx xxxxxxxxxx@xxx0xxxx.xxx or drop off at the CAP Shelter. Thank you!

In case of Illness. If a child is exhibiting any signs of illness, upset stomach, a cough or elevated temperature, the child cannot attend camp for that day. In the event that a child is unable to return to complete the camp there will be no refunds. I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me. Parent/Guardian name (print): Parent/Guardian signature: Date: Please note: CAP is not a licensed child care facility and is exempt from regulations from the TX Dept. of Family and Protective Services. Emergency Contacts & Authorized Transportation If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact? #1 Emergency Contact Person Name (NOT PARENT): Relationship: Daytime / Cell phone #: Please list anyone (other than parents/guardians) who is authorized to pick up your child from camp: I, hereby authorize that Citizens for Animal Protection can release my child to parent/guardian’s full name the following person(s). Name: DL State & # Phone#: (If anyone other than those listed above is to pick up my child, I need to notify CAP Kids & Kritters Camp staff at drop-off. Drop-Off / Pick-Up Arrangements CAP Kids & Kritters Winter Break Day-Camp Hours are 9 a.m. – 1pm. (CAP does not offer extended childcare options at this time.) Children can begin to arrive at CAP Kids & Kritters Camps no earlier than 8:45 a.m. All campers must be dropped off at side gate located on west side of the CAP Animal Shelter and signed in with the Kids & Kritters Camp staff. Please do not drive up and let your child/children walk into the facility alone. Campers will be ready to be picked up at side gate located on the west side of the CAP Animal Shelter at noon. each day. Campers will be released only to those persons whom the parent or guardian has designated on the program registration form. These persons may be asked to show proper identification at the time of pick-up. If you are late picking up your child, a late fee of $1.00 per minute beginning at 1:10 p.m. will be charged and due at the time you pick up your child. Your child/children need to be signed in and out by the parent/guardian or the persons who have been designated on this registration form. Waiver of Liability, Permission Form, and Release of Images ● I am the legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I understand that all participants including myself are expected to abide by all rules and guidelines established by Citizens for Animal Protection (CAP) during the camp. ● I understand that my child will be participating in activities at Citizens for Animal Protection (CAP) and that in the course of such activities the child will have direct contact with various animals such as walking dogs and feeding cats and rabbits. ● I further understand that while all precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing the risks of interacting with animals, on behalf of my child and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any of its officers, directors, employees, agents, or contractors for any and all personal injury or property damages resulting from my child’s participation in camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities. ● I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP. ● I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use. Parent/Guardian name (print): Parent/Guardian signature: Date: Payment Information ⭘ I have enclosed a check for $ per child per day camp. (Please make checks payable to Citizens for Animal Protection or CAP.) □ Please charge my credit card ⭘ Visa ⭘ MasterCard ⭘ AmEx ⭘ Discover Cardholder Name: Account #: Exp. Date: Signature: Date: Please note reservations for campers will not be held without full payment. Print, complete and submit application via email to xxx0xxxx@xxx0xxxx.xxx xxxxxxx@xxx0xxxx.xxx or drop off at the CAP Shelter. Thank you!

In case of Illness. If a child is exhibiting any signs of illness, upset stomach, sick with a cough communicable disease or elevated temperaturewith a fever, the child cannot attend camp for that day. If the illness persists for more than one day, a medical release must be turned in by the parent/guardian before the child returns back to camp. In the event that a child is in unable to return to complete the camp there will be no refunds. I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me. Parent/Guardian name (print): Parent/Guardian signature: Date: Please note: CAP is not a licensed child care facility and is exempt from regulations from the TX Dept. of Family and Protective Services. Emergency Contacts & Authorized Transportation If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact? #1 Emergency Contact Person Name (NOT PARENT): Relationship: Daytime / Cell phone #: Please list anyone #2 Emergency Contact Person Name (other than parents/guardians) who is authorized to pick up your child from campNOT PARENT): Relationship: I, hereby authorize that Citizens for Animal Protection can release my child to parent/guardian’s full name the following person(s). Name: DL State & # PhoneDaytime / Cell phone #: (If anyone other than those listed above is to pick up my child, I need to notify CAP Kids & Kritters Camp staff at drop-off. Drop-Off / Pick-Up Arrangements CAP Kids & Kritters Winter Spring Break Day-Day Camp Hours are 9 a.m. – 1pm. 3 p.m. (CAP does not offer extended childcare options at this time.) Children can begin to arrive at CAP Kids & Kritters Camps Camp no earlier than 8:45 a.m. All campers must be dropped off at side gate located on west side of the CAP Animal Shelter and signed in with the Kids & Kritters Camp staff. Please do not drive up and let your child/children walk into the facility alone. Campers will be ready to be picked up at side gate located on the west side of the CAP Animal Shelter at noon. 3 p.m. each day. Campers will be released only to those persons whom the parent or guardian has designated on the program registration form. These persons may be asked to show proper identification at the time of pick-up. If you are late picking up your child, a late fee of $1.00 per minute beginning at 1:10 3:10 p.m. will be charged and due at the time you pick up your child. Your child/children need to be signed in and out by the parent/guardian or the persons who have been designated on this registration form. Waiver of LiabilityAuthorized Transportation Please list anyone (other than parents/guardians) who is authorized to pick up your child from camp: I, Permission Form, and Release of Images ● I am the legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I understand hereby authorize that all participants including myself are expected to abide by all rules and guidelines established by Citizens for Animal Protection can parent/guardian’s full name release my child/children to the following person(s). (CAPDrivers License # and Phone # is required.) during the camp. ● Name: DL State & # Phone#: Name: DL State & # Phone#: (If anyone other than those listed above is to pick up my child, I understand that my child will be participating in activities at need to notify Citizens for Animal Protection (CAPKids & Kritters Camp staff in writing to arodriguez@cap4pets .org and supply the staff with the name and drivers license number of the authorized adult.) General Camp Rules • Listen and that follow instructions • Participate in camp activities • Hands, feet and objects to yourself • Cell phone use only allowed when directed by staff • Never go anywhere without asking your Camp Counselor • Show respect for others – All CAP staff, volunteers, fellow campers and animals • Respect all property and show responsibility for yourself and your actions • Have FUN! Rules are posted in the course of such activities education center and are reviewed with the campers each morning. In the event a child will have direct contact with various animals such as walking dogs and feeding cats and rabbitsis disruptive, a time-out may be used. ● I further understand that while all precautions are taken to ensure participant safetyIf disruptive behavior continues or is severe, the parent will be called to help find a solution. If improvement is not realized, parent/guardian will be contacted and asked to pick up the camper. Examples of unacceptable behavior include inappropriate language, making fun of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing or insulting others, bullying, using profanity, harming or frightening the risks of interacting with animals, on behalf physically harming others, not following directions or unwelcome actions that make other campers feel uncomfortable. In the event of my child a termination from the program, the parent/guardian will be notified personally. There will be no refunds. Every effort is made to accommodate campers with special needs, including campers with behavioral challenges. Parents/guardians of children who need special attention or have behavioral challenges must notify us of the issue in the "Health Information and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any Special Needs" section of its officers, directors, employees, agents, the registration form. Campers with behavioral disorders that may continuously interfere with or contractors for any and all personal injury or property damages resulting from my child’s participation in disrupt the camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities. ● I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP. ● I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or program may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use. Parent/Guardian name (print): Parent/Guardian signature: Date: Payment Information ⭘ I have enclosed a check for $ per child per day camp. (Please make checks payable to Citizens for Animal Protection or CAPsuitable campers.) □ Please charge my credit card ⭘ Visa ⭘ MasterCard ⭘ AmEx ⭘ Discover Cardholder Name: Account #: Exp. Date: Signature: Date: Please note reservations for campers will not be held without full payment. Print, complete and submit application via email to xxx0xxxx@xxx0xxxx.xxx or drop off at the CAP Shelter. Thank you!

In case of Illness. If a child is exhibiting any signs of illnessill ness, upset stomach, a cough or elevated temperature, the child cannot attend camp for that day. In the event that a child is in unable to return to complete the camp there will be no refunds. I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me. Parent/Guardian name (print): Parent/Guardian signature: Date: Please note: CAP is not a licensed child care facility and is exempt from regulations from the TX Dept. of Family and Protective Services. Emergency Contacts & Authorized Transportation If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact? #1 Emergency Contact Person Name (NOT PARENT): Relationship: Daytime / Cell phone #: Please list anyone (other than parents/guardians) who is authorized to pick up your child from camp: I, hereby authorize that Citizens for Animal Protection can release my child to parent/guardian’s full name the following person(s). Name: DL State & # Phone#: (If anyone other than those listed above is to pick up my child, I need to notify CAP Kids & Kritters Camp staff at drop-off. Drop-Off / Pick-Up Arrangements CAP Kids & Kritters Winter Summer Break Day-Camp Hours are 9 8 a.m. – 1pmnoon. (CAP does not offer extended childcare options at this time.) Children can begin to arrive at CAP Kids & Kritters Camps no earlier than 8:45 7:45 a.m. All campers must be dropped off at side gate located on west side of the CAP Animal Shelter and signed in with the Kids & Kritters Camp staff. Please do not drive up and let your child/children walk into the facility alone. Campers will be ready to be picked up at side gate located on the west side of the CAP Animal Shelter at noon. each day. Campers will be released only to those persons whom the parent or guardian has designated on the program registration form. These persons may be asked to show proper identification at the time of pick-up. If you are late picking up your child, a late fee of $1.00 per minute beginning at 1:10 12:10 p.m. will be charged and due at the time you pick up your child. Your child/children need to be signed in and out by the parent/guardian or the persons who have been designated on this registration form. Waiver of LiabilityLiability , Permission Form, and Form Release of Images ● • I am the legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I understand that all participants including myself are expected to abide by all rules and guidelines established by Citizens for Animal Protection (CAP) during the camp. ● • I understand that my child will be participating in activities at Citizens for Animal Protection (CAP) and that in the course of such activities the child will have direct contact with various animals such as walking dogs and feeding cats and rabbits. ● • I further understand that while all precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing the risks of interacting with animals, on behalf of my child and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any of its officers, directors, employees, agents, or contractors for any and all personal injury or property damages resulting from my child’s participation in camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities. ● • I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP. ● • I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use. Parent/Guardian name (print): Parent/Guardian signature: Date: Payment Information ⭘ 🞏 I have enclosed a check for $ $50.00 per child per day camp. (Please make checks payable to Citizens for Animal Protection or CAP.) □ 🞏 Please charge my credit card ⭘ 🞏 Visa ⭘ 🞏 MasterCard ⭘ 🞏 AmEx ⭘ 🞏 Discover Cardholder Name: Account #: Exp. Date: Signature: Date: Please note reservations for campers will not be held without with out full payment. Print, complete and submit application via email to xxx0xxxx@xxx0xxxx.xxx xxxxxxxxxx@xxx0xxxx.xxx or drop off at the CAP Shelter. Thank you!

In case of Illness. If a child is exhibiting any signs of illnessill ness, upset stomach, a cough or elevated temperature, the child cannot attend camp for that day. In the event that a child is in unable to return to complete the camp there will be no refunds. I do hereby give the staff of Citizens for Animal Protection permission to seek medical attention from either a private doctor or the nearest hospital. I designate the staff of Citizens for Animal Protection to act on my behalf in seeking medical attention and any other issues involving the welfare of my child. I understand every attempt will be made to contact me by Citizens for Animal Protection staff. By my signature and of my own free will, I represent that: (1) I am the parent/guardian of the child and that all information provided above is true. (2) I agree to the terms and the conditions set out above, including the camp rules, and (3) that I do hereby release and agree to indemnify and hold harmless Citizens for Animal Protection from any and all claims and demands, cost or expenses arising out of any injuries or damage sustained by the child or me. Parent/Guardian name (print): Parent/Guardian signature: Date: Please note: CAP is not a licensed child care facility and is exempt from regulations from the TX Dept. of Family and Protective Services. Emergency Contacts & Authorized Transportation If the parent(s)/guardian(s) listed above cannot be reached in case of an emergency, who else may we contact? #1 Emergency Contact Person Name (NOT PARENT): Relationship: Daytime / Cell phone #: Please list anyone (other than parents/guardians) who is authorized to pick up your child from camp: I, hereby authorize that Citizens for Animal Protection can release my child to parent/guardian’s full name the following person(s). Name: DL State & # Phone#: (If anyone other than those listed above is to pick up my child, I need to notify CAP Kids & Kritters Camp staff at drop-off. Drop-Off / Pick-Up Arrangements CAP Kids & Kritters Winter Break Day-Camp Hours are 9 8 a.m. – 1pmnoon. (CAP does not offer extended childcare options at this time.) Children can begin to arrive at CAP Kids & Kritters Camps no earlier than 8:45 7:45 a.m. All campers must be dropped off at side gate located on west side of the CAP Animal Shelter and signed in with the Kids & Kritters Camp staff. Please do not drive up and let your child/children walk into the facility alone. Campers will be ready to be picked up at side gate located on the west side of the CAP Animal Shelter at noon. each day. Campers will be released only to those persons whom the parent or guardian has designated on the program registration form. These persons may be asked to show proper identification at the time of pick-up. If you are late picking up your child, a late fee of $1.00 per minute beginning at 1:10 12:10 p.m. will be charged and due at the time you pick up your child. Your child/children need to be signed in and out by the parent/guardian or the persons who have been designated on this registration form. Waiver of LiabilityLiability , Permission Form, and Form Release of Images ● • I am the legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I understand that all participants including myself are expected to abide by all rules and guidelines established by Citizens for Animal Protection (CAP) during the camp. ● • I understand that my child will be participating in activities at Citizens for Animal Protection (CAP) and that in the course of such activities the child will have direct contact with various animals such as walking dogs and feeding cats and rabbits. ● • I further understand that while all precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that animals are capable of inflicting serious personal injury. Knowing the risks of interacting with animals, on behalf of my child and myself, I agree to assume those risks and release, indemnify, and hold harmless CAP and/or any of its officers, directors, employees, agents, or contractors for any and all personal injury or property damages resulting from my child’s participation in camp activities. I agree to hold Citizens for Animal Protection harmless for any and all claims for injuries, causes for action or liability related to use of all Citizens for Animal Protection facilities. ● • I give CAP authority to seek emergency medical treatment for my child. I know of no medical or other condition that would prevent my child from participation in activities at CAP. ● • I hereby grant permission to Citizens for Animal Protection (CAP) to take and use: photographs and/or digital images of me and of my child/children for use in brochures, news releases, educational materials and any other lawful purposes. These materials may include printed or electronic publications, web sites or other electronic communications. I further agree that my name or my child’s name and identity may or may not be revealed in descriptive text or commentary in connection with the image(s). All negatives, prints, digital reproductions shall be the property of Citizens for Animal Protection. I hereby release CAP and any of their directors, officers, agents, employees and appointed printing/advertising companies and their directors, officers, agents, and employees from all claims of every kind on account of such use. Parent/Guardian name (print): Parent/Guardian signature: Date: Payment Information ⭘  I have enclosed a check for $ $50.00 per child per day camp. (Please make checks payable to Citizens for Animal Protection or CAP.) □  Please charge my credit card ⭘  Visa ⭘  MasterCard ⭘  AmEx ⭘  Discover Cardholder Name: Account #: Exp. Date: Signature: Date: Please note reservations for campers will not be held without with out full payment. Print, complete and submit application via email to xxx0xxxx@xxx0xxxx.xxx xxxxxxxxxx@xxx0xxxx.xxx or drop off at the CAP Shelter. Thank you!