Registration Form

Registration: Camp Pawprint Day Camps (10-27-2016 - 06-09-2017 )

Registration is open for these day camps (more dates to come)!  Day Camps are recommended for children 7-13. Campers will enjoy animal-related lessons and activities, while having fun with other animal lovers! Camp activities include animal interactions, humane education lessons, service projects, group games, animal crafts, and daily presentations from local animal experts.

USER INFORMATION
First Name:
Last Name:
Camper Information - One child only! If registering multiple children, please register each one separately. Please wait 10 minutes between registrations so our system can reset. Thank You!
Camper First Name:
Camper Last Name:
Gender:
Male  Female  
Birthday (mm/dd/yyyy):
Medical or behavioral conditions we should be aware of:
Days I will attend:
October 27 (closed)
October 28 (closed)
November 11 (closed)
December 26 (closed)
December 27 (closed)
December 28 (closed)
December 29 (closed)
December 30 (closed)
January 2 (full)
January 3 (full)
January 16(closed)
March 24
March 31
April 10
April 11
April 12
April 13
April 14
Aftercare is available from 3-5pm. Aftercare Fee $10 X (# of days):
I am a DCHS Member:
Yes - will receive a 15% discount on camp fees
Parent Information (if participant under age 18)
Please include full contact information for the primary guardian of your camper in the first set of fields and emergency contact in the second set of fields.
Guardian First Name:
Guardian Last Name:
Address:
City:
State:
ZIP:
Contact Email:
Phone:
Emergency Contact First Name:
Emergency Contact Last Name:
What is the emergency contact's relationship to the camper (ie. . father, mother, grandparent):
Email:
Phone:
The undersigned parent or guardian of the above named child (“Minor”) hereby consents to the Minor participating in Camp Pawprint of Dane County Humane Society, Madison, Wisconsin (the “Society”) and all of its activities and programs. The undersigned, for herself or himself and on behalf of said Minor, does hereby and unconditionally release, indemnify, hold harmless and forever discharge the Society, its employees, successors, assigns, and agents and each of them, from and against any and all claims, demands, obligations and liabilities of every nature and kind whatsoever, including, without limitation, negligence, occurring during, directly or indirectly resulting from or arising out of the Minor’s participation in such Camp Pawprint. As to matters covered hereby, the CONSENT AND RELEASE shall extinguish all claims, demands, and rights which the undersigned or the Minor (and/or each of their heirs, successors, and assigns) has or may have against the parties released hereby, or any of them, for any injuries, costs or damages to the Minor occurring during, directly or indirectly resulting from or arising out of the Minor’s participation in such Camp Pawprint whether such injuries, costs or damages are known or unknown, foreseen or unforeseen, ascertainable or unascertainable. The undersigned also agrees that Dane County Humane Society may photograph the Minor’s participation in Camp Pawprint and hereby releases any such photographs to Dane County Humane Society for its use in programs, publications and purpose.
Signed:
Yes
Name:
Date:
How did you hear about this event?: