BRIGHTON SUMMER MADNESS- CHILDREN'S BONANZA

Age Range*

	6	7	8	9	10	11	12

6 is Youngest, 12 is Oldest

Please Click On Top 3 Preferred Activities

Emergency Contact Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Do you have any chronic illness or medical conditions?*

YesNo
Please describe*
Release of Liability

The safety of all participants within every activity taking place is our primary concern, we will not be held liable for any causes to injuries and/or death.

I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Summer Madness Series Team.
I have read and agree to the above conditions*

YesNo
After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at Brightonsummermadness@gmail.com
SUMMER MADNESS BONAZA ACTIVITY TIMETABLE

Fri 21st & Sat 22nd july 2017
Should be Empty: