About Michael V. Novak
About mljamms enterprises
mljamms enterprises deejay service
Jammin' With Jesus
To Destiny (The band)
Keynote Speaker & Animator
mljamms enterprises publishing
Michael V. Novak books
WRITE NOW CAMP REGISTRATION IS CLOSED
Write Now! Camp Registration
Indicates required field
July 6, 2014 - July 9, 2014
July 10, 2014 -July 13, 2014
Please click which Session your child will attend. Session arrival time is 4:00 pm and Pick up time is at 4:00 pm.
Age of participant at time of camp participation
Gender for cabin assignments
I Agree to the terms and conditions associated with my child participating in the Write Now! Camp activities. In addition I authorize Write Now! inc. L.L.C. to *This release form is completed and electronically signed of my own free will:
By typing in your name you are electronically signing and agreeing to all conditions listed above.
Release of Liability and parent/Guardian's Agreement/Authorization/Release
If you would like your child to participate in this event, please complete, sign, and return this statement of consent, release of
liability and medical treatment authorization. As parent or legal guardian, you remain fully responsible for the actions and conduct of your child while participating in all Write Now! Camp activities and field trips. I understand that this event will take place at Hawk Woods and your child will be under the supervision of the designated Write Now! camp administrator and staff on the dates listed above. I further consent that transportation will be provided by Write Now! administrator and/or Write Now! staff.
In consideration of my child being allowed to participate in this event, I hereby agree on behalf of myself and my child, to release mljamms enterprises, Write Now! inc. L.L.C., The city of Auburn Hills, Hawk Woods and any and all affiliated organizations, their employees, agents and representatives, including volunteers and volunteer drivers (collectively "Releasees"), from any and all claims, including negligence, which may be asserted by me or my child, or on behalf of my child, arising from or relating to my child's participation in this event. In the event this release on behalf of myself and/or my child is held to be invalid or unenforceable , I hereby agree to indemnify and hold harmless "Releasees" from any and all claims, including negligence, which may be asserted by me or my child, behalf of my child, arising from or relating to my child's participation in this event. This release or indemnification does not apply to claims for intentional misconduct or gross negligence; Nor does this release or indemnification apply to the extent of commercial insurance coverage for any claim, but this release or indemnification shall apply to the extent of any self-insurance or deductible applicable to any claim.
In addition, as parent/legal guardian, I do hereby authorize the treatment of a qualified or licensed medical doctor in an emergency which, in the opinion of the attending physician, may endanger my child's life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me.
As parent/guardian, I further consent to the use of my child's likeness and written submissions n promotional materials
published by or on behalf of Write Now! inc. LLC, including on web sites and social media sites afﬁliated with Write Now! inc. LLC, and the Releasing Parties grant the Released Parties, for valuable consideration received, the absolute and irrevocable right and unrestricted permission concerning any photographs or written submissions taken of the Releasing Parties at Write Now! inspirational writing camp to
use, reuse, publish, and republish the photographs or written submissions in whole or in part, individually or in
connection with other material, in any and all media now or hereafter known, including the
internet and published works, and for any purpose whatsoever, speciﬁcally including illustration, promotion, art,
editorial, advertising, prose, poetry, and trade, without restriction as to alteration. The Releasing Parties
release the Released parties from any and all claims and demands that may arise out of or in connection with the use of the photographs, or written submissions including without limitation any and all claims for libel or violation of any right of publicity or privacy.
Parent phone number
Parent Email address
please provide a valid Email address so we can send you payment confirmation and additional Write Now! camp information.
Physician Phone Number
Health Insurance Company
please type in your insurance company name: EXAMPLE: BLUE CROSS, HAP, COFINITY ect....
Health insurance Policy number
This number will be located on the front of your insurance card and is usually listed as the member Id, Identification number or contract number.
Someone we may get in contact with if we are unable to reach you.
Emergency contact phone number
I am paying by check
I am paying by credit card
if paying by check, select check payment option then the submit registration button (you will not need to go to the add to cart option.) Make Check payable to Write Now! Mail to 7276 Continental Ave, Warren MI 48091. *Please note Child will not be fully registered until check clears. If paying by credit card select the credit card option then the submit registration button. click add to cart and put in your card information.
Create your own unique website with customizable templates.