Friends of the Cobbossee Watershed · Tadpole Patrol Registration

Contact Information

Parent/Guardian Name

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First Name

Last Name

Contact Phone Number

*

Email

*

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Emergency Contact (Not on Boat)

*

First Name

Last Name

Emergency Contact Phone Number

*

Participant Name & Age (Only list age if participant is under 18)

*

Participant Name & Age (Only list age if participant is under 18)

Custom text

Location, Date and Time of Seesion

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Location, Date and Time of Session (If Second Session Requested)

Liability & Waiver Agreement

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By signing below, I hereby indemnify and hold harmless FOCW and supporting Agencies, and release any sponsors and representatives from all claims or liabilities arising from our groups participation. Additionally, I give permission to FOCW to use photographs or images of our groups participants for appropriate promotional materials.

Responsible Participant Agreement

Amount - $50 per session

*

$100

$50

$

Additional Information for Education Director Cami Wilbert

Reservation Confirmation

Your registration is NOT confirmed until a confirmation email is sent by the Friends Education & Outreach Director, Cami Wilbert, with directions and additional information. Please add cami@watershedfriends.com to your email contacts if you have a strong filter on your email inbox. In the event that we cannot accomodate your date and time preferences, your registration fee will be reimbursed.