W Program and Workshop Registration

Please provide participant information below, along with which programs/workshops you wish to register for. All information will be collected per registrant, with the opportunity to add additional registrants in Section 2.

Please note that all information collected in this form will be kept strictly confidential.

SECTION 1

Participant Information:

Program/Workshop Interest

Parent/Guardian Information:

Emergency Contact (if guardian(s) cannot be reached):

Transportation Needs

In some cases, YWCA Cambridge may provide families with support to transport participants to programming at The W.

Getting To Know Our Participants

This confidential information will be used solely to help us in getting to know your child and better understanding how we can best support them.

Health And Wellness

SECTION 2 If Needed

Second Participant Information:

Parent/Guardian Information

Second Participant Emergency Contact (if parents cannot be reached):

Getting To Know Our Participants

This confidential information will be used solely to help us in getting to know your child and better understanding how we can best support them.

Please check words that best describe your child:
Please check ALL THAT APPLY
We want your camper to enjoy his/her time at camp. Please provide us with the following information so that we can make her/his camp experience great. Information will remain confidential.

Please indicate if your participant has any of the following:

SECTION 4

SECTION 5

Permissions and Waivers

Photography

Your child may participate in an event or activity hosted by YWCA Cambridge where photos/video or audio recordings of participants may be taken for the purpose of representing The W in promotional materials for YWCA Cambridge. Guardians with children or youth under the age of 18 must sign this consent form in order to protect the participant’s safety and privacy. 

By selecting yes below, you are consenting to:
Give consent to have photos/video/film/audio of your child(ren) taken and used in the promotional materials for YWCA Cambridge and/or The W.  You understand that their image(s) may be published or used in promotional and marketing materials including, but not limited to, brochures, website graphics, social media etc. or otherwise displayed to the public or used for other educational/advertising/fundraising purposes, either in whole or in part by YWCA Cambridge. I give consent to have photos/video/film/audio of my child taken and used in the promotional materials for YWCA Cambridge and/or The W. 

Waiver of Claims

I consent to allow my child to participate in activities at and hosted by The W and/or YWCA Cambridge. I
release any legal recourse against The W and YWCA Cambridge and all claims resulting from personal
injury. In the case of emergency, I authorize The W staff to act on my behalf and transport my child to
the nearest medical facility by ambulance or taxi at my cost. In the case where participants will be
traveling to an activity, I am aware that the outings take place off-site from the original drop-off/pickup
site of The W unless otherwise indicated.

Scroll to Top