Education Department Release Forms

Big Brother Big Sister Release Form

Child's Name(Required)
Child's Gender
MM slash DD slash YYYY
Names of parent/guardian(Required)
Big Brother/Big Sister Name(Required)
Does your child require any special accomodations?(Required)
Note about Allergies(Required)
Please note that children may encounter a number of common potential allergens while at camp, including dog, cat, and rabbit dander, nut, wheat, and dairy products, etc. Due to the nature of our work, we cannot guarantee an environment free from any allergens. Children who bring an Epipen to camp must carry it with them at all times (a fanny pack might be helpful).
Minor Injuries(Required)
Photo Release(Required)
The Humane Society of Broward County sometimes uses photos and videos (which may feature my child) taken during our kids programs in promotional and educational materials such as brochures, flyers, our website, social media, etc.
General Release(Required)
I, the parent or guardian of the child I am registering (“minor”) hereby consent to the minor participating in the Humane Society of Broward County’s (HSBC) camp program and all of its activities. I understand that the minor child I am registering may have direct contact with domestic and exotic animals. I further understand that the behavior of domestic and exotic animals is sometimes unpredictable and that some domestic and exotic animals are capable of inflicting serious personal injury. The undersigned, for himself or herself and on behalf of said minor, does hereby absolutely and unconditionally release, indemnify, hold harmless and forever discharge HSBC, its officers, directors, employees, successors, assigns, agents, and volunteers, 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 minor’s participation in camp. As to matters covered hereby, this 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 ever have against the parties released hereby, or any of them, for injuries, costs or damages to the minor occurring during, directly or indirectly resulting from or arising out of minor’s participation in HSBC’s camp whether such injuries, costs or damages are known or unknown, foreseen or unforeseen, ascertainable or unascertainable.