E RELEASES

VIX CAMPS RELEASE FORM
I am fully aware that camping, survival, tracking, and awareness training, even under the safest conditions possible may be dangerous, and I hereby agree to accept full responsibility and assume any and all risks, including those caused by acts of God, injury, death, and/or loss to my person and/or property knowingly and voluntarily. I understand that participation in these activities contains certain risks of physical injury. I agree to assume fully the risk of injury arising from any such activity. In the event that I am injured while attending Victor Wooten’s Center for Music and Nature at Wooten Woods or any other facility as deemed necessary by Victor Wooten’s Center for Music and Nature and require the attention of a doctor, I consent to any reasonable medical treatment determined necessary by a licensed physician or EMT. In the event that treatment is needed, I do agree and hereby hold such persons, Victor Wooten, Victor Wooten’s Center for Music and Nature, all staff, and all volunteers thereof, free and harmless of any liability, claims, demands, or suits for damages arising from the giving of such consent for treatment administered by or under the supervision of a licensed physician or EMT. I agree and do hereby release and hold such persons, Victor Wooten, Victor Wooten's Center for Music and Nature, all camp staff, and all volunteers thereof, free and harmless of any and all liability, claims, demands, or suits for damages arising from any situation, including, but not limited to, all third party actions or liability in connection with any and all activities, transportation, or accommodations for the camp. I hereby authorize Victor Wooten's Center for Music and Nature to use any photographs or likeness of me for any promotional purposes.
Name *
Name
Date *
Date
Primary Phone *
Primary Phone
Other Phone
Other Phone
 

 
AUTHORIZATION OF TREATMENT FORM
In case of medical emergency, I hereby give permission to the medical personnel selected by a camp staff member to order X-rays, routine tests, treatment, to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation for me. I hereby give permission to the physician selected by the camp staff member to secure and administer treatment for me, including hospitalization.
Name *
Name
Date *
Date
 

 
VIX CAMPS PARENTAL RELEASE FORM
I, the undersigned, am the parent, the parent having legal custody, or the legal guardian of the undersigned camper, give my consent for him/her to participate in Victor Wooten’s Center for Music and Nature at Wooten Woods and/or any other facility as deemed necessary by Victor Wooten‘s Center for Music and Nature. I am fully aware that camping, survival, tracking, and awareness training, even under the safest conditions possible, may be dangerous, and I hereby agree to accept full responsibility and assume any and all risks including those caused by acts of God for all injury, death, and/or loss to his/her person and/or property knowingly and voluntarily. I understand that participation in these activities contains certain risks of physical injury. I agree to assume fully the risk of injury arising from any and all such activity. In the event that he/she is injured while attending this camp and requires the attention of a doctor, I consent to any reasonable medical treatment as deemed necessary by a licensed physician or EMT. If, because of an emergency, it becomes necessary for camp staff to give consent for me, or if there is not time or opportunity to make a telephone call or any other reasonable form of communication including, but not limited to electronic, I agree and do hereby release and hold such persons: Victor Wooten, Victor Wooten's Center for Music and Nature, all camp staff and all volunteers thereof free and harmless of any and all liability, claims, demands, or suits for damages arising from the giving of such consent for treatment administered by or under the supervision of a licensed physician or EMT. I agree and do hereby release and hold such persons: Victor Wooten, Victor Wooten's Center for Music and Nature, all camp staff and all volunteers thereof free and harmless of any and all liability, claims, demands, or suits for damages arising from any situation including, but not limited to, all third party actions or liability in connection with any and all activities, transportation, or accommodations for the camp. I hereby authorize Victor Wooten's Center for Music and Nature to use any photographs or likeness of my child for any promotional purposes.
Name of Camper *
Name of Camper
Date *
Date
Name of Parent/Guardian *
Name of Parent/Guardian
Date *
Date
Parent/Guardian Phone 1 *
Parent/Guardian Phone 1
Parent/Guardian Phone 2
Parent/Guardian Phone 2