BECOME A CMA MEMBER TODAY
AND RECEIVE $40 OFF EACH SPRING BREAK AND/OR SUMMER CAMP!

Membership Information

Personal Information

Medical Information

Additional emergency contacts:

Authorized Pick-Up

Please provide the names and relationships for those authorized to pick up your child. Remember to include yourself. We will NOT release your child to anyone, including you or a relative, unless the name is listed below.

I, the undersigned, in my individual capacity as parent or guardian of , age , being a minor child, hereby release and hold harmless Clearwater Marine Aquarium, its officers, employees, instructors and supervisors from any and all liability or damages, both personal and property, arising out of or as a result of said minor child's attendance at spring break and/or summer camps. I assume all risks incident thereto with respect to myself and to any other individuals from whom the registration is made. I give permission for Clearwater Marine Aquarium, its officers, employees, instructors and supervisors to provide routine health care, administer prescribed medication and seek medical treatment if an accident arises.

Clearwater Marine Aquarium occasionally takes photos of participating children for use in its newsletters and publications. Also, on occasion, local news media may visit our facilities in covering various events. By signing this permission slip, I acknowledge awareness that my child’s photograph may be taken at times for promotional or news coverage purposes. I understand that photos taken by Clearwater Marine Aquarium become property of the organization and may be used in promotional materials.