Camp Zenith Indemnity Form

Camp Details:

Hosting Camp for:

Please select the age of the guest:

What we do with your data

Camper Details:

Name:

Surname:

Age:

Medical Conditions / Allergies?

Parent/Legal Guardian Details:

Full Name:

Email:

Cell:

Relation:

In Case of Emergency:

1st Person:

Cell:

2nd Person:

Cell:

I declare that:

I consent to my child attending at Camp Zenith. I understand that although safety is regarded a priority at Camp Zenith, the activities that my child may engage in always carry risks and dangers that could result in damage to property or persons.

I confirm that Camp Zenith does not take any responsibility for any theft or loss of, or damage or destruction to any property of whatever nature brought onto the Camp Zenith premises by my child.

I hereby indemnify and agree to hold harmless, Camp Zenith, its staff as well as their authorised agents and/or representatives, and , against actions, proceedings, claims, demands, liabilities, losses and reasonable costs and expenses whatsoever in respect of, or in connection with damage or loss to property, real or personal, and injury to persons, including injury resulting in death, arising out of or as a consequence of my child's participation at the camp, save that liability will not be excluded under this indemnity for loss occasioned by gross negligence and/or wilful misconduct attributable to Camp Zenith.

I consent to photos being taken and used for Camp Zenith Marketing
Please email me a copy of this indemnity form.
After camp, I'd like to participate is a short evaluation.
I'd like to receive Camp Zenith's monthly newsletter

Sign:

Submit
Note: The "SUBMIT" button will become available once a signature is signed in the above box.

I understand that although safety is regarded a priority at Camp Zenith, the activities that I may engage in always carry risks and dangers that could result in damage to property or persons.

I agree to be bound by the rules of Camp Zenith.

I confirm that Camp Zenith does not take any responsibility for any theft or loss of, or damage or destruction to any property of whatever nature brought onto the Camp Zenith premises by myself.

I hereby indemnify and agree to hold harmless, Camp Zenith, its staff as well as their authorised agents and/or representatives, and , against actions, proceedings, claims, demands, liabilities, losses and reasonable costs and expenses whatsoever in respect of, or in connection with damage or loss to property, real or personal, and injury to persons, including injury resulting in death, arising out of or as a consequence of my participation at the camp, save that liability will not be excluded under this indemnity for loss occasioned by gross negligence and/or wilful misconduct attributable to Camp Zenith.

Sign:

Submit
Note: The "SUBMIT" button will become available once a signature is signed in the above box.