7:45am – 3:00pm Whitney Institute
3:00pm – 5:30pm After camp care

Fees: $150 per child (after camp care $50) Sibling rate $130 per child

I agree to my child’s attendance at the above mentioned camp.

In the case of emergency, I authorize the program staff, where it is impracticable to communicate with me, to arrange for my child to receive such medical or surgical treatment as may be deemed necessary. I also undertake to pay or reimburse costs which may be incurred for medical attention, ambulance transport and drugs while my child is enrolled with the program.

I understand that although the BCB and its service providers attempt to minimize risk of personal injury within practical boundaries, accidents do happen and all physical activities carry the risk of personal injury. I acknowledge that there is an inherent risk of personal injury in physical activities that will be undertaken as part of this program and I agree that my child undertakes the activities at his/her own risk.

I release and indemnify the BCB and its officers, servants, agents and service providers against all actions, suits, claims, demands, proceedings, losses, damages, compensation, costs, charges and any expenses whatsoever arising directly or indirectly out of any personal injury to my child howsoever occasioned.

I also agree any photos taken may be used in BCB promotional materials (websites, posters, etc.).

(1) All prescription drugs must be registered on this form.

(2) All prescription drugs, except those which must be kept on the camp member’s person for emergency use, must be kept and distributed by the BCB staff.

(3) Check here if there are NO special problems that the BCB staff should be aware of and no prescription drugs are required on the trip. [ ]

(4) If any medication or prescription drugs are to be taken by the camp member, list them here (Name of drug and reason):

As the parent/guardian of the above child, I recognize that too much exposure to UV rays may increase my child’s risk of developing skin cancer. Therefore, I give permission for the staff at:

BERMUDA CRICKET BOARD

to apply a sunscreen product that is broad spectrum with SPF 30 or higher to my child every 2 hours as specified below, when he/she will be playing outside, especially during the months of April through November and between the daily time of 10am – 4pm. I understand that sunscreen may be applied to exposed skin, including but not limited to the face (except eyelids), tops of ears, nose, bare shoulders, arms and legs.

hereby release the Bermuda Cricket Board, and their agents, employees and/or officers and Board of Directors from any liability of personal injury, death, or property damage through my child’s participation in the BCB Summer Clinic.

I am fully aware, understand and acknowledge that my child(ren) will be will be playing cricket games at various locations around the island. I am fully aware, understand and acknowledge that my child will be accompanied by a Camp counselor but that walking to games or catching the bus to games for example has inherent risks associated with it. I knowingly assume those risks, release and covenant not to sue the Bermuda Cricket Board for any liability whatsoever resulting from my child’s participation in any part of this clinic.

The undersigned hereby agrees to indemnify and save and hold harmless the Bermuda Cricket Board from any loss, liability, damage, or cost that may occur as a result of my minor child’s participation in the clinic. The undersigned hereby assumes full responsibility for and risk of bodily injury, death, or property damage due to negligence of the Bermuda Cricket Board.

The undersigned has read and voluntarily signs the release and waiver of liability and indemnity agreement, and further agrees that no oral representations, statements, or inducement apart from the foregoing writing agreement have been made.