• Registrants

  • Child's Name Program Actions
       
    There are no Children.

    Maximum number of children reached.

  • Parent/Guardian

  • Emergency Contact

  • Payment

    Payment Plan:
    Pay deposit of $250 (non-refundable) and 10 payments of $125 (per child / per program) from September to June

    OR

    One-time Payment:
    Pay $1350 (per child / per program) up front and save $150.

    *** Discount of 20% for third child and after. ***

  • Consent for Medical Treatment

    In the event that I cannot be reached in an emergency requiring medical attention for the above named child, permission is hereby given for the staff of TimberNook programming whom are CPR/first aid certified to administer CPR and/or first aid as deemed necessary. Further permission is given to allow medical services to be performed by doctors, hospitals or other qualified medical providers as deemed necessary in an emergency, including surgery if reasonably necessary. I understand that the cost of all emergency services is my responsibility.

    NOTE: If you have any medical condition that a TimberNook provider should be aware of it; is your responsibility to let us know of the existing condition prior to the start of any program. The information will be held in confidence and used only to render assistance should the need arise.
  • Photo Release

    Occasionally photos and video-taping will be taken during program and may be used for TimberNook publications including its website and Facebook page. However, we will not identify your child by name or release any personal information.
  • Sunscreen and Bug Spray

    Would you like us to reapply sunscreen and bug spray throughout the day as needed. (Please supply these for your child)
  • Liability Release Waiver and Authorization Form

    Participation at a TimberNook location exposes participants to certain risks of being in the outdoors. Accidents and injuries resulting from the forces of mother nature, live animal and bug interactions, slipping and falling, malfunctioning equipment, unseen obstacles, fatigue, and your own and others’ misjudgment are very real possibilities.

    Affirmation and Liability Release

    THE UNDERSIGNED CERTIFY THAT THEY AGREE AS FOLLOWS:

    1. I hereby affirm that I have been informed that there are inherent dangers of being outdoors at a nature program.
    2. While all program participants are consistently well supervised, accidents do happen. The undersigned(s) assume(s) all risk of injury or harm to the child associated with participation in the program and agree(s) to release, indemnify, defend and forever discharge TimberNook and it's staff, employees, and agents of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action in respect of death, injury, loss or damage to the child, or by the child, howsoever caused, arising or to arise by reason of or during the child's participation in the program.
    3. I hereby agree to heed at all times the advice and instructions of the TimberNook and its owners to practice common sense while at this program.
    4. The above named participant, a minor child has permission to participate in the activities of TimberNook programming.

    By signing this document, I acknowledge that if anyone is hurt or property is damaged during my child’s participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against the TimberNook provider and TimberNook, LLC on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read & understood it, and I agree to be bound by its terms.