Event Registration

Pioneer Day Camp-Trailblazers I
06/15/2021 09:00 AM - 06/19/2021 04:00 PM CST
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Waiver Statement:

Child to follow Community and Safety Guidelines:
My digital signature below acknowledges that I understand my child will be expected to follow the Lincoln Log Cabin Rules For Participation and Safety On The Farms Guidelines. If my child repeatedly refuses to follow these guidelines, I understand my child will be dismissed from the program and I will be asked to pick him/her up. I realize any disciplined Summer Youth Volunteer or Pioneer Camper who is sent home at any time will forfeit their Summer Youth or Pioneer Camp fees.

Use of Likeness:
I also give my permission for Lincoln Log Cabin State Historic Site to use any photographs or videos taken of my child for promotional purposes, and to post these photos/videos to social media and/or affiliated websites.


Emergency Medical Authorization

The medical information provided on this form regarding my child is correct to the best of my knowledge. I have read the Youth Volunteer Rules of Participation and give my permission for my child to engage in all learning and recreational activities at Lincoln Log Cabin. I certify that my child is able to participate in those activities and that all medical conditions or allergies of my child which may limit my child’s participation in activities are listed in the next section of this registration.

IN THE EVENT I CANNOT BE REACHED IN CASE OF EMERGENCY, I HEREBY AUTHORIZE LINCOLN LOG CABIN STATE HISTORIC SITE; IT’S OFFICERS, DIRECTORS, EMPLOYEES OR DESIGNATED PERSONNEL TO GIVE MEDICAL ASSISTANCE TO MY CHILD. I ACCEPT FULL RESPONSIBILITY FOR PAYMENT OF EXPENSES INCURRED AS A RESULT OF ANY MEDICAL TREATMENT FOR MY CHILD.

In consideration for my child being allowed to be a Young Adult Interpter or Pioneer Camper at Lincoln Log Cabin, I agree to hold harmless and release Lincoln Log Cabin, it’s directors, officers, employees and volunteers from liability for any fault, mistake, negligence, or omission causing damage, loss, injury, or death to me or my child (hereinafter referred to jointly as Damage) arising from my child’s attendance at Lincoln Log Cabin State Historic Site, including any Damage arising from the provision of emergency medical treatment.

By checking below, I indicate that I agree and that I have reviewed the Handbook, which details new policies and procedures regarding COVID-19.

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