2018 Junior Lifeguard Camp Registration

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1 Sign up for A power packed week of coaching in first aid, water safety, team building, CPR & rescue techniques for only $ Sessions fill up quickly! Participant Name: DOB: Age: Grade in Fall 2018: Parent or Guardian Name: Phone #: Alternate Phone #: Address: City: State: Zip Code: Circle the session(s) your camper will attend: 2018 Junior Lifeguard Camp Registration Session Date Range Session Grade Range A June X Grades 6 th -8 th B June Grades 3 rd -5 th Grades 6 th -8 th C July 9-13 X Grades 6 th -8 th D July Grades 3 rd -5 th Grades 6 th -8 th E July X Grades 6 th -8 th F July 30-August 3 Grades 3 rd -5 th Grades 6 th -8 th G August 6-10 Grades 3 rd -5 th Grades 6 th -8 th H August X Grades 6 th -8 th Souvenir Rash Guard Provided to Every Camper! *Camper must be at least 8 years old Grades 6 th -8 th will be certified in First Aid & CPR! Youth Small Youth Medium Youth Large Youth X-Large Adult Small Adult Medium Adult Large Adult X-Large Circle your camper s size above. Ways to Save! A B C D E F G H Passholder Discount: 2018 Season Passholders receive $20 off their camp registration! Don t have a Season Pass yet? Upgrade now to enjoy unlimited visits and exclusive Passholder benefits in 2018 and you ll qualify for this discount. Sibling Discount: Save $10 off registration for each additional sibling! Returner Discount: Previous campers save $10 off registration! Discount also applies to additional sessions when booking multiple sessions in the 2018 Season. Optional Additions Camp Meal Deal: Save time & money with our discounted Meal Deal! With a Jr. Lifeguard Camp Meal Deal your camper can enjoy lunch each day of camp, & a FREE Souvenir Cup to use all season for just $49.99! Passholder Savings: Add a Passholder exclusive Season Pass Meal Plan to receive one combo meal with a beverage every day of the 2018 season. Ask for additional details. Equip your camper with practical souvenirs of their Junior Lifeguard experience! o Camper Bundle: Hip Pack, CPR keychain & a pair of Ocean Breeze Waterpark sunglasses for $19.99 o Junior Lifeguard Camp Backpack for $7.99 o Junior Lifeguard Camp Water Bottle for $7.99 Continue registration on the next page

2 2018 Junior Lifeguard Camp Registration Continued Item Quantity Price Total Junior Lifeguard Camp Session 2018 $ Discounts 2018 Passholder Discount (-$20) Sibling Discount (-$10) Returner Discount (-$10) Optional Additions Camper Meal Deal $55.64* Camper Bundle $21.19* Camp Backpack $8.46* Camper Sweatshirt $26.49* Camp Water Bottle $8.46* *Prices listed include tax. Policies & Procedures Refunds & Cancellation Policy: A nonrefundable 50% deposit is required to secure a spot in each session. Cancellation: While the 50% deposit is non-refundable, any additional payments may be refunded if the cancellation is made at least a week prior to the camp start date. (Signature of Parent or Guardian) (Printed Name) (Date) Total Registration Form & Payment Submission: Note that session spots are not secured until all forms are completed and a 50% deposit is processed. All forms must be completed & submitted to make a deposit. Form Submission Methods: camp@oceanbreezewaterpark.com Fax: Mail: Attention: Junior Lifeguard Camp 849 General Booth Blvd. Virginia Beach, VA Accepted Payment Forms: cash, credit card or check. Payment Submission Methods: All payment types are accepted in the office during off-season business hours or anytime within the 2018 Season operating schedule. Checks made out to Ocean Breeze Waterpark also accepted by mail. Credit card payments also accepted over the phone.

3 2018 Junior Lifeguard Medical Release Form Participant Name: DOB: Age: Parent or Guardian Name: Phone #: Alternate Phone #: Address: City: State: Zip Code: Emergency Contacts: Are there any known medical conditions? Are there any special precautions to be observed during training? Medications Medication needed during the course of the camp will need to be provided to Ocean Breeze Waterpark staff in the correct dosage amounts needed for the week. These medications will be keep in our First Aid Station and will be self-administered by your participant according to the times and dosage listed below. Medications must be properly labeled with the participant s name and the information listed below. Medication 1: Type: Dosage & Time: Medication 2: Type: Dosage & Time: Medication 3: Type: Dosage & Time: Additional Medication Notes: Continue Medical Release on the next page

4 2018 Junior Lifeguard Medical Release Form Continued Allergies Does the participant have any known allergies? Yes No Please list all that apply: Food Related Allergies All camp participants are able to pack their lunches for the camp week in which they are participating. No glass containers are allowed and their lunch should be packed in an insulated container with some type of ice pack. Two snacks are provided for every participant, each day. Food & Beverage: The park has a wide assortment of foods and beverages available, including bottled water. Allergies: We are not the food manufacturers/suppliers (we get all food and beverage product from third parties), and as such, we regret to inform you that THE PARK CANNOT, AND DOES NOT, MAKE ANY REPRESENTATIONS OR GUARANTIES WHATSOEVER REGARDING THE ALLERGY-FREE CONTENTS OF ANY FOODS OR BEVERAGES. At a minimum, guests with allergy concerns should avoid any foods or beverages unless they are packaged, and you are 100% confident in the manufacturer/supplier which has provided the park with such food or beverage. Foods that are in any way unpackaged, prepared, or handled by the park (as opposed to packaged goods, provided to you in a sealed package), have a higher risk of contamination with other products containing allergens, so in the interests of your safety, we strongly urge you to avoid all such unpackaged products provided by the park. Epi-Pen Does the participant have an Epi-Pen prescribed by a physician? Yes No Ocean Breeze Waterpark staff is willing to assist with the administration of the Epi-Pen under the following conditions: The Epi-Pen must be provided to Ocean Breeze Waterpark staff. Ocean Breeze Waterpark staff will not administer unless it is a life-threatening situation and the participant is unable to self-administer the injection. You acknowledge that there are certain side effects and risk associated with administration of the Epi-Pen. You agree to release from any and all liability of cause of action Ocean Breeze Waterpark and its employees from any and every claim, demand, action or right of action, or whatsoever kind of nature, either in law or in equity arising from or by reason of any bodily injury or personal injuries known or unknown or death resulting on account of the Epi-Pen injection administered to the participant while participating in the program. Medical Release In case of a medical emergency, I hereby give my permission to Ocean Breeze Waterpark to administer emergency care and to secure proper treatment, transportation and/or Emergency Room treatment for my child/camp participant from the dates of to. (Signature of Parent or Guardian) (Printed Name) (Date)

5 2018 Junior Lifeguard Camp Waiver for Participation For DOB: (Participant Name) I, (Participant s Parent or Guardian) do hereby agree to allow the child named here to participate in Junior Lifeguard Camp. I understand there is risk inherent in the activities at the park premises and I, for myself and/or dependents, assert responsibility and assume all such risks inherent in the participation of activities, the use of the facilities, the conduct of other parties, and the amenities available on the park premises. I am aware of the possibility of accidental or other physical injury which may befall my child during their use of the facility, equipment and participation in Junior Lifeguard Camp conducted by Ocean Breeze Waterpark. I further agree to indemnify, hold harmless the park and its affiliated companies, their agents, employees, and volunteers from and to waive any and all claims, causes of action, demands, and liabilities for any personal injury, property damage, which may be suffered by the aforementioned individual arising out of or in any way connected with their participation in this activity. I understand that my child must abide by all park rules and policies, as well as the instructions of Ocean Breeze Waterpark staff. Ocean Breeze Waterpark is not liable for any lost or stolen objects. I grant Ocean Breeze Waterpark the right to film/videotape/photograph the participant on park property for any purpose without payment or consideration thereof. Swimming Ability: To participate and enjoy camp to the fullest, participants should be capable of keeping their heads above water, treading and swimming in deep water without assistance, and swimming under water. Regardless of their swimming ability, participants will be required to wear a lifejacket when their instructor deems it necessary. (Signature of Parent or Guardian) (Printed Name) (Date) Additional Contact Information Names of people other than the parent or guardian listed above allowed to pick-up the participant. Names of people NOT allowed to pick-up the participant. ID s are required and each participant must be signed out by authorized person(s) daily. Additional contacts must be added in person by the parent or guardian. Parent or guardian must have an I.D. Pick-up contacts cannot be added by phone.

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