Day Camps Your Name (required) Your Email (required) Your Phone # (required) Your Address (required) Child's Name, DOB and Entering Grade Level (required) Child's Name, DOB and Entering Grade Level If registering 3 or more children, enter in all the children's names, DOBs and entering grade levels here Allergies or any special instructions? Please provide an alternate contact person in case of emergency (Name, Phone, Relationship please - REQUIRED) Please indicate which camp session(s) your child(ren) will be attending: Winter Camp, December 8th Please include anything else we might need to know regarding your registration: I give permission for my child/children to participate in activities at SafeHaven Humane Society. I am doing so entirely on my own initiative, risk, and responsibility. I hereby for myself, my heirs, my executors' remise, release and discharge SafeHaven Humane Society, its officers, and employees from all claims, demands, actions, or cause of action on account of any injury to me, my child, or my property which may occur during my time at SafeHaven. I also give SafeHaven Humane Society permission to use photos/footage of my child(ren) in future publications in regards to SafeHaven’s Humane Education programs. Please contact Katie at email@example.com or call 541-926-2924 for questions!