Please complete one form per child. You will be able to add additional children at the end of this form.










Cancellation Policy

Please note any cancellations made less than two weeks from the camp start date will result in a 50% charge to your member account. Any cancellation after the start of camp will result in a full member charge. Children removed from camp due to behavioral issues will incur a full member charge.

Waiver Statement
I authorize my child's full participation in White Manor Country Club's Summer Camp, including related activities. I understand the activities are not without some inherent risk of injury. In consideration of my child's right to participate in this activity, I agree to release, waive, discharge and agree not to sue and agree to hold harmless for any and all purposes White Manor Country Club and its directors, officers, agents, and volunteers from any and all liabilities, claims or injuries, including death, that may be sustained while participating in camp activities or while on premises owned or controlled by Releasees, including injuries sustained as a result of the negligence of Releasees. I understand this release does not apply to injuries cause by intentional or grossly negligent conduct on the part of the Releasees. I further agree to indemnify and hold harmless Releasees from any loss, liability, claim or injury caused by my child while participating in camp activities. I also give my permission for my child to receive any emergency medical treatment by a healthcare professional, including emergency medical transportation, which may be required for injuries sustained by my child. I agree to indemnify and hold harmless Releasees for any costs incurred to treat my child, even if a Releasee has signed hospital documentation promising to pay for treatment.

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