Camp Strand Family Day Saturday

September 9, 2017 | 8:30 am-6:00 pm Camp Twin Lakes – Will-A-Way 210 S. Broad Street Unit 5 Winder, GA 30680

Registration

All registration forms must be completed and submitted by August 25, 2017.

Registration fee: $50.00 for a family of 4

The registration fee covers all informational sessions, activities, lunch, dinner and refreshments for each person up to a family of 4.

Each additional person will be charged a fee of $10.

Once registration forms are received a confirmation email will be sent with details regarding Family Day activities.

Camp Strand
1280 Heatherland Drive
Atlanta, GA 30331

For additional information please contact us via email at us campstrand@gmail.com .

1 Registration Form

Name*
First Last
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Name (person in family with Alopecia)*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
If child:
Mother’s Name
First Last
Father’s Name
First Last
Siblings Name and Age
Parent/Caregiver Phone Number
Parent/Caregiver Emergency Number
If parent:
Address (If different from above)
Street Address Address Line 2 City State ZIP Code
Total number of family members attending Family Day
Name of Participants
PHOTO & WEB RELEASE*
- Yes I approve of the Photo & Web Release
We give our permission for Camp Strand/Melvin Jones Foundation to use any photos for any promotional materials.
Parent/Guardian Initials:*

Please list all allergies (food or environmental):
Please list any activities that participants of Camp Strand Family Day should be restricted:
Please identify any medical conditions:
I hereby certify that the named participants are in good health and fully able to participate in all activities of Camp Strand Family Day and that I know of no restrictions, physical impairments, or any other facts, which in any manner limit his/her participation in such a program.*
- Yes
Parent/Guardian Initials:*

RELEASE OF LIABILITY – READ BEFORE SIGNING*
- Yes I agree
I acknowledge, appreciate, and agree that: 1. The risk of serious injury from all Camp Strand Family Day activities involved in this program is always present due to the nature of the activity. 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my or my child’s participation. 3. I willingly agree to comply with the program’s stated and customary terms and conditions for myself or my child’s participation. 4. It is expressly understood and agreed that Camp Strand, Melvin Jones Foundation, and Camp Twin Lakes and all of the board members and planning committee and individuals involved shall not be responsible or legally liable for any losses of personal property or for any bodily injuries, or the results thereof, incurred and suffered by the applicant or in connection with any activities or programs. I hereby acknowledge that I am voluntarily participating in this event and agree to assume any such risks.
Parent/Guardian Initials:*
Today's Date*
Date Format: MM slash DD slash YYYY
Registration Fee (Family of 4)
Price: $50.00 Quantity:
The registration fee covers all informational sessions, activities, lunch, dinner and refreshments for each person up to a family of 4.
Additional Person = $10
Each additional person will be charged a fee of $10.
Total
$0.00
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