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Family Wilderness Skills Weekend | May 28-30, 2021
Final Participant Information & Release of Liability
*
Indicates required field
Please List the Primary Attendee on your Reservation
*
First
Last
Type any adult ticketholder's name here so we can verify your registration.
Have you been to the Primitive Camp before?
*
Yes
No
How will your family get into camp?
*
Drive 4x4 vehicle (returning families)
Meet at Wells Mills and follow 4E Staff (requires 4WD/AWD)
Shuttle ride from with 4E Staff (contact <a href = "mailto: jamie@4eee.org">Jamie@4eee.org</a>!) **
* IMPORTANT: If you will park a vehicle at Wells Mills Park and get a ride into the Primitive Camp from 4E Staff, please provide the Make/Model/License Plate Number of the vehicle that will be parked overnight Friday and Saturday.
Vehicle Make
*
Vehicle Model
*
License Plate #
*
Any known allergies (food/environmental) or dietary restrictions requiring special accommodation? If none for your family, please write 'none'.
*
Please list any medical conditions and/or medications we should be aware of. If there are none for your family, please write 'none'.
*
Is there anything else we whould know?
*
RELEASE OF LIABILITY.
I understand that my participation is strictly voluntary and may involve risk of bodily harm or death from various hazards, both obvious and obscure, including but not limited to: trips and falls, extreme sun and heat, being struck by falling objects, encounters with defensive plants and wild critters, weather exposure and plenty more... By typing my name below as a digital signature and submitting this form, I acknowledge and assume responsibility for any and all possible risks. I affirm that 4 Elements Earth Education (4E), its employees, event staff, volunteers, board members, property owners, family of the same, and any organization that 4E represents or contracts with shall be held harmless and blameless in the event of any trouble or mishap. On behalf of myself and my family, my heirs and representatives, I do hereby irrevocably release 4E, its employees, staff, volunteers, board members, property owners, families of the same, and associated organizations from any and all claims which involve any nature of injury or death or damage to persons or property that may occur as a result of attendance or participation by anyone listed on this form.
Typed Digital Signature for Release of Liability
*
Please let us know if you have any questions or concerns in advance of this event. See you in the Pine Barrens later this month!
4 Elements Earth Education | www.4eee.org | 530-265-2036 | info@4eee.org
Submit!
Home
Programs
Fox Walkers Youth Programs (CA)
>
Field Trip Inquiry
Coyote Tracks Programs (PA & NJ)
Teens & Families
Scholarships
Calendar
About
About Our Team
Teaching Philosophy
Honoring Indigenous Land and Teachings
Board of Directors
Videos
Directions and Map
Join Our Team
FAQS
Support
Auction
Give Now
Volunteer
Contact
Blog
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