STATEMENT PARTICIPATION RECORD

(Confidential Record)

Please print clearly using one form for each child.

Mon Tue Wed Thu Fri

Week 1 ☐ 11th ☐ 12th ☐ 13th ☐ 14th ☐ 15th

Week 2 ☐ 18th ☐ 19th ☐ 20th ☐ 21st ☐ 22nd

Week 3 ☐ 25th ☐ 26th ☐ 27th ☐ 28th ☐ 29th

Participant Name (Child)

Date of Birth (dd/mm/yyyy):
Home Address:
City:
Country:
Home Phone:
Name:
Relationship to Child:
Primary Phone:
Secondary Phone:
E-mail:

__________________
Parents Signature

Emergency Contact Information*

2nd Emergency Contact
Name:
Relationship to Child:
Primary Phone: ☐ Home ☐ Work ☐ Cell
Secondary Phone: ☐ Home ☐ Work ☐ Cell
E-mail:
*whilst Participant is at Kids Camp
Camp Participant Profile
Does your child have any medical conditions, allergies or phobias that we need to be
aware of? For example, allergies to e.g. insect bites, chlorinated water, grass, face paints,
medicines or food of any kind including nuts, milk or any other dietary restrictions. Please
specify all medical conditions we need to be aware of.

Are there any other special considerations we need to be aware of in taking care of your
child? Please provide exhaustive details.

Is your child able to swim? Please initial. ☐ Yes _______ ☐ No _______

Is your child physically fit? Please initial. ☐ Yes _______ ☐ No _______

Photography Rights and Other Information

I consent to photographs taken of my
child/children being taken and shared on
social media (EP Mandarin Oriental). Photos ☐ Yes _______ ☐ No _______
may be used for marketing purposes. Please
initial.
How did you hear about the camp?
☐ Direct Mail ☐ Facebook ☐ Guest/Member/Visitor at EP Mandarin Oriental
☐ Instagram ☐ Friend ☐ Other (please specify):
____________________________
We may send you details of future camps or events and activities that we think may
interest you. ☐ I do not wish to receive information
 PROGRAMME GUIDELINES

By registering for the camp, you are agreeing to the terms and conditions stated and are agreeing
to the declaration on the following page:

• Only children of ages between 3 and 12 years old are allowed to participate in the program.
• All parents/ guardians must sign in their children in the register at the time of drop off.
• At the end of the day children will be handed over to the registered names in the record.
• Prior information and email indicating the person/s authorized to pick up the children must
be sent to MOAUH-beachclub@mohg.com at least 2 hours before the pick- up.
• Person/s authorized to pick the children by parents must provide their valid Emirates I/D
copy. All children must be picked up within the stated time.
• Parents/guardians/nannies are not allowed at the activity venue during normal operations.
• Siblings will not be allowed at the venue to keep the participants company.
• Proper attire must be brought by the participant.
• Preferred sun protection cream may be carried for protections from sun-burn.
• In case an item is left at the venue, standard Lost & Found procedures will be followed.
• Emirates Palace Mandarin Oriental Abu Dhabi cannot be held responsible for the loss or
damage of any personal belongings brought to the camp.
• Personal toys, mobile phones, play gadgets, sharp objects etc. are not allowed within the
activity venue.
• All personal effects, which cannot be kept at the Beach Club will be sent back with the
parent/s or guardians.
• Repeated verbal abuse will not be tolerated and parents will be notified on the same day if a
child is seen/heard using inappropriate language.
• Disciplinary action may be taken where appropriate leading to terminating day’s session of
child/children involved.
• The list of guidelines is indicative and may be modified based on the situation at hand,
bearing in mind the safety and well-being of the child/children.
• Additional rules may be applied by the venue in-charge considering the environment or
surroundings. More information will be included in the Parent Information Guide.

DECLARATION

I hereby affirm that I am aware and understand the kids camp rules as far as my child’s attendance
in this area is concerned and attendance of the related activities. By signing this release, I assume
total responsibility for my child whilst he/she is in the Emirates Palace Mandarin Oriental Abu
Dhabi staff care. I understand that there are certain risks associated with participation in the
programme.
Furthermore, I acknowledge the Emirates Place Mandarin Oriental Abu Dhabi Hotel will not be
held responsible or liable for any loss, damage or injury (including fatality) to my child or their
property whilst in the care of the Kids camp staff.
My child is fit for the program(s) in which I have enrolled him/her. I hereby release and shall
defend, indemnify and hold harmless releases from every claim and any liability that I or my child
may allege (including reasonable legal fees and costs) as a direct or indirect result of injury or
death to Me or my child because of my child’s participation in the program, whether caused by the
negligence of releases or others to the maximum extent permitted by law. I will not sue releases
on my behalf or on behalf of my child regarding any claim arising from or related to my child’s
participation in any Emirates Palace Mandarin Oriental Abu Dhabi programme(s).

I acknowledge that, by signing this document, I am releasing Emirates Palace Mandarin Oriental
Abu Dhabi and their Representatives, agents, employees, volunteers, members, sponsors,
promoters, and affiliates (collectively “releasees”) from liability, and that I am giving up
substantial legal rights. This sign up and release form is a contract with legal and binding
consequences and it applies to all activities in which my child engages during the program,
regardless of whether such activity is a part of a formal program. I have read this release carefully
before signing. I understand what this release means and what I am agreeing to by signing.

Whilst I acknowledge that precautions are taken to prevent and or limit any injury to my child, in
the event of a medical emergency I permit and consent to the medical treatment of my child by
Emergency First Responders, Paramedics and Medical Staff and agree to meet the cost of all such
treatment.

By registering for this program, I understand and agree that if a portion of the program is unable
to be completed due to unforeseen circumstances which are not under responsibility of Emirates
Palace Mandarin Oriental Abu Dhabi, I will notify Emirates Palace Mandarin Oriental Abu Dhabi
at least 24 hours to reschedule to another date within 11th December to 29th December 2023. I also
understand that no refunds or proration will be given for any other reason.

I further state that I am of lawful age and legally competent to sign this Assumption of
Risk and Liability Release Agreement and as the parent am providing written consent for
the participation of my child.

Parent Name: _______________________________

Relationship to Participant: _______________________________

Signature: _______________________________