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RWFP Summer Camp Release Form

  1. If there are listings in this section please contact the Rutledge-Wilson Farm Community Park prior to the program. The concerns listed on this form in no way limit your child’s participation in this program.

  2. My family and I hereby waive and release the Springfield-Greene County Park Board and its representatives from claims of damages and/or injuries incurred while participating in or as a spectator of the Springfield-Greene county Park Board activities.

  3. Please type your First and Last Name

  4. I give my permission for me and/or my child to be photographed while participating in Park Board activities, and to use any photographs of me and/or my child for Park Board promotional purposes

  5. Please type your First and Last Name

  6. I will allow the following authorized person(s) to pick up my child,

  7. from programs at Rutledge-Wilson Farm Park. Only the following authorized person(s) will be permitted to pick up my child unless park staff has been notified with written notice. I understand that the authorized person(s) listed will be required to show a photo ID when picking up my child.

  8. Please type your First and Last Name

  9. Leave This Blank:

  10. This field is not part of the form submission.