Summer Family Camp

Registration closes at midnight on June 19th. Parents are free and do not need to register. Please email rlincoln@brit.org with any questions or concerns.

Click in the boxes below to enter the number of participants:

	June 23: Morning - Non-Member Child $12
	June 23: Morning - Member Child $10
	June 23: Afternoon - Non-Member Child $12
	June 23: Afternoon - Member Child $10
	June 24: Morning - Non-Member Child $12
	June 24: Morning - Member Child $10
	June 24: Afternoon - Non-Member Child $12
	June 24: Afternoon - Member Child $10

Order Total:

$0.00

Camper Information:

Camper's First and Last Name: *

Date of Birth: * +

If you registered more than one child, please add their name(s) below:

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Additional camper's date of birth:

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Please list any additional information you would like for us to know about your camper(s):

Parent/Guardian Information:

First Name: *

Last Name: *

Email: *

Second Parent/Guardian First Name:

Second Parent/Guardian Last Name:

Email:

Are you a returning Spring Break Family Camp participant? *

Yes

No

Release of Liability and Use of Image by Parent/Guardian of Child Participant in a Botanical Research Institute of Texas Program

Name of Program: Spring Break Family Camp 2020

Date of Program: March 10 & 11, 2020

Camper's First and Last Name: *

Date of Birth: * +

If you registered more than one child, please add their names below:

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Additional camper's date of birth:

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As the parent and/or legal guardian of the child named above, I wish for my child to participate in the Botanical Research Institute of Texas (BRIT) program identified above ("Name of Program"). I understand there are possible dangers associated with the program, including but not limited to biting and/or stinging insects, animals, adverse weather conditions, etc.

I understand that my child's participation in the program may involve sustained physical activity. My child is in good health, and I am aware of no physical problem or condition that will limit or interfere with my child's ability to participate in the program.

I agree that my child is participating in the program at my own risk and acknowledge that BRIT has made no warranty or representation, expressed or implied, regarding the safety of conducting the program.

I agree and understand that photographs, which include my child's image taken at the program, may be used in BRIT's publications for advertising, publicity, and commercial or other business purposes. I hereby give BRIT permission to duplicate and distribute the photographs, or any parts there of, which include my child's image, in perpetuity in any manner and in any and all media, including the internet, whether known now or hereafter devised. I waive any right to inspect or approve the finished version(s).

By signing here I express that I DO NOT agree for my child's image to be used for any of the above purposes or posted on the internet:

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I expressly release and hold harmless BRIT and its officers, directors, employees, agents, licensees, successors, and assigns from and for any and all claims, demands, actions, and causes of action whatsoever on account of any loss, damage, or injury to person or to property suffered or incurred by my child, except by BRIT's negligence, in connection with the program or any aspect of it, including, but not limited to, any transportation arranged by, paid for, or provided by BRIT.

This release shall be binding upon me and my heirs, next of kin, executors, and assigns. By signing below, I acknowledge that I have thoroughly read and understand this form and that the statements I have made are all true. Parent/Guardian Signature: *

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Please print your name: *

Date: * +

Registrant Information

First Name *

Last Name *

Email Address *

Phone Number *

GROW Member Number (Only if registered as a member):

Street Address *

Address Line 2

City *

State *

Zip Code *