Edit Form Please complete one form for each child and submit. When you pay online you may combine the payments into one lump sum for all campers being registered. Please email a copy of your online payment receipt to tgrout@ci.shorewood.mn.us. If you have questions, please call the city at 952.960.7902. Camper's Name* Parent/Guardian Name* Parent/Guardian Email* Parent daytime phone* Address* City/Zip* Paragraph Grade 2021-2022* T-shirt size (youth): S, M, L, XL* Emergency contact for during camp hours: Name* Phone during camp hours* Relationship to camper* Friend request (one permitted; we will do our best to group them together)* Medical concerns or allergies (put NA if none):* Photographs will be taken during the event and shared on social media, newsletter, newspaper and future promotion. Names will not be included. If you do not want your child's picture taken, please let the camp director know by email prior to camp, tgrout@ci.shorewood.mn.us. Data Privacy/Tennessen Warning* The Minnesota Data Privacy At requires that the registration information you provide on this form remain as private data. Private data is available to you but not to the public. While you may choose to withohold this private data, there may be consequences that could limit the distribution of information to the participant. By signing below, you are consenting to allow registration to be shared with the instructor and other program participants for purposes of administering the activity. The consent will expire upon completion of this activity. Hold Harmless Waiver of Liability* I the undersigned parent or guardian, inconsideration of my being permitted to participate in this activity, do hereby agree to hold harmless the City of Shorewood, Excelsior Fire District, South Lake Minnetonka Police Department, and its employees and agents from any and all liability for any personal injury or death which may occur from participation in this activity. This waiver includes any injuries which may result from the condition of facilities and any improvements thereto.
