Camp Registration – Houston

Houston, TX Camp Registration

May 8 & 9, 2026


Camper Details

Camper Name
Address
Parent Name

Additional Camper Details

What is your comfort level with hands-on building or construction activities?
There are no right or wrong answers!

Emergency & Medical Details

Do you have any food allergies?
Do you have any additional allergies or medical concerns?
If none, please enter N/A
Please list the name(s) of the people you (the parent/legal guardian) authorize to pick up your child from camp each day.

Waiver & Liability Release

Waivers and liability releases must be signed by a parent or legal guardian.

Media Release

By checking this box, I, as the parent or legal guardian of the participant, grant Women Building America, Inc. (hereinafter referred to as “the WBA”) permission to use photographs, video recordings, or audio of my child taken during the volunteer activities for promotional or informational purposes, in any medium, without compensation.

Media Release

Liability Waiver & Release (Parent/Guardian Signature Required)

I hereby represent and certify that I am the parent or legal guardian of the minor participant named in this registration and that I consent to their participation in camp programs, volunteer opportunities, and related recreational activities organized by Women Building America, Inc. (“WBA”).

I have advised my child, and my child understands, that they must follow all rules and instructions provided by WBA staff, volunteers, and adult chaperones. My child agrees to act responsibly, avoid behavior that could cause harm to themselves or others, and seek assistance from an adult chaperone if they become aware of any unsafe or hazardous condition.

I agree, on behalf of myself and my child, to assume all risks and responsibilities associated with my child’s participation. To the fullest extent permitted by law, I agree to release, indemnify, defend, and hold harmless Women Building America, Inc., and its directors, officers, employees, agents, and volunteers from any and all claims, demands, actions, losses, damages, liabilities, or expenses (including attorney fees and court costs) arising from or related to my child’s participation, regardless of fault or cause.

I understand that WBA shall have no responsibility or obligation to pay for medical treatment or related expenses if my child is injured during participation in these activities. I authorize WBA staff or volunteers to provide or obtain emergency medical care for my child if deemed necessary and agree to be financially responsible for any resulting costs.

I certify that I am at least eighteen (18) years of age and that I have carefully read and fully understand this Liability Waiver & Release (For Minor Child). I freely and voluntarily agree to its terms and acknowledge that no oral or written statements can alter this document. This agreement shall be governed and interpreted in accordance with applicable laws in the jurisdiction where the program activities occur.

Liability Waiver & Release
Clear Signature

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