Destination Sitters Supervised Activities

Registering for Bush Bro & Co - 06/25/2026 - 06/27/2026 Change

DESTINATION SITTERS SUPERVISED ACTIVITIES

Enrollment Form: Please fill this form out completely

Person/s dropping child off – picking child up, and signatures below. Government issued photo ID required.

Authorization for Emergency Medical Attention

MEDICAL WAIVER: In the event that I/we, [FIRST NAME] [LAST NAME], parent(s)/guardian(s)of [PARTICIPANT NAMES] cannot be reached, I/We hereby authorize Destination Sitters, LLC to (or anyone acting on their behalf), to seek any and all emergency medical attention needed for the above named child/children, including, but not limited to, if necessary, taking the child/children (by ambulance, if necessary) to the nearest hospital or clinic where medical services can be obtained. I/we further state that I/we will be solely responsible for any and all medical costs, ambulance fees, or other costs that might be incurred because of that emergency and that I/we will indemnify and hold harmless Destination Sitters, LLC or their agents or employees from any and all liability arising out of the aforementioned medical emergency.

Parent Information

First Name *

Last Name *

Mobile Number *

Email Address *

Address *

Address Line 2

City *

State/Province *

Zip/Postal Code *

Location and phone number where parent/guardian can be reached at all times:

Phone Number*

Location*

Where will you be on property?

Drop Off

Name of person who will drop off child/children*

Relationship to child/children*

Pick Up

Name of person who will pick up child/children*

Relationship to child/children*

Emergency Contact Information, if parents are unavailable:

Name*

Phone Number*

Relationship to child/children*

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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.

Destination Sitters Supervised Activities

Registering for Bush Bro & Co - 06/25/2026 - 06/27/2026 Change

Parent Information

Location and phone number where parent/guardian can be reached at all times:

Drop Off

Pick Up

Emergency Contact Information, if parents are unavailable:

Child Information: