I hereby give my consent to attend Easterseals Wisconsin Camps, located in Wisconsin Dells, Wisconsin, and give permission to go with the Easterseals Wisconsin camp staff on field trips during the 2020-2021 camp sessions. In consideration for the acceptance for myself and family members I hereby release and waive any claim or cause of action which may occur against Easterseals Wisconsin and employees or any other person acting with permission arising out of any injury to his/her person or property during his/her stay at the session, in transit to and from said session, or during any activity approved by and of said persons for injury as herein stated. I have read the foregoing release and authorization before affixing my signature below, and warrant that I fully understand the contents thereof.

Easterseals Wisconsin will run a National Sex Offender (NSOPW) Background Check on all participants 18 years or older attending in the Veterans Family Camp session. Please list all legal names of individuals 18 years or older in the space below. Approval of registration for each participant is contingent upon successful completion of a NSPOW check. Positive convictions within the database may disqualify a participant from attending the camp program. Participants my request a copy of their NSOPW check at any time.