Boyd Ranch - Kid's Club Registration Parent or Guardian RegistrationParent or Guardian's Name First Name Last Name Parent or Guardian's PhoneParent or Guardian's Email Is the EMERGENCY CONTACT the same as above? Yes No Emergency Contact's Name First Name Last Name Emergency Contact's PhoneEmergency Contact's RelationshipAddress Street Address Address Line 2 City STAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Camper RegistrationListCamper's NameNicknameAgeKnown Allergies Add RemoveConsent and ReleasesPhotography Consent(Required) I agree to the Photography Consent.The Desert Caballeros Western Museum, Boyd Ranch, may occasionally photograph or videotape events for educational, funding and publicity purposes only. Please sign below to indicate your awareness of the Museum's policy on photographing participants.Consent to Emergency Medical Care(Required) I authorize medical care to be given by emergency room staff or paramedics in case of an emergency. Every effort will be made to notify emergency name and number first.Release of Liability(Required) I agree to the Release of Liability policy.In considermion of tbe acceptance of my request to participate in the Desert Caballeros Western Museum's Boyd Ranch Kids Club and Boyd Ranch Pony Club, l do hereby for and on behalf of myself, my heirs and legal representatives and my children release and forever discharge the Maricopa County Historical Society's Desert Caballeros Western Museum, its employees and agents, officers, directors, trustees, committees, volunteers, instructors, all other participants involved in the activities, and their successors, of all claims or clauses of actions of every kind, nature or character which I have or may be suffered or sustained by me in connection with activities during the said event and all such claims are hereby waived and released and I covenant not to sue therefore. I assume all risks associated with any participation in the program. I further acknowledge that my participation in these activities is permitted only upon my execution of this instrument and that my participation is purely volunta1y. Signature of Parent or Guardian(Required)Printed Name of Parent or Guardian(Required)Date(Required) MM slash DD slash YYYY
