2025-2026 Eagle Bear Nation Registration EARLY BIRD SPECIAL! HURRY! Please enable JavaScript in your browser to complete this form.Child InformationName *FirstLastDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Princess or Guide *Princess (Female)Guide (Male)Date / TimeDateTimeName of School *Name of Tribe *Second Child InformationChild NameFirstLastDate of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Princess or GuidePrincess (Female)Guide (Male)Name of SchoolName of TribeThird Child InformationChild NameFirstLastDate of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Princess or GuidePrincess (Female)Guide (Male)Name of SchoolName of TribeParent/Guardian InformationName *FirstLastEmail *Phone *Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDriver's License * Drag & Drop Files, Choose Files to Upload Must upload a copy of State ID or Driver’s LicenseEmergency ContactName *FirstLastPhone *TERMS & CONDITIONS *I have read Terms & Conditions I give EAGLE BEAR NATION LLC permission to take photographs and video footage of my child and Agree to the EAGLE BEAR NATION Policies and/or Guidelines that include child abuse prevention, use of off-road vehicles, and the abuse of alcohol. All policies will be reviewed at the FIRST Chief Meeting with location to be announced. Eagle Bear Nation Staff, Volunteers, and Participants work by a code. This code was put in place to establish appropriate behavior. We are expected to conduct ourselves in a manner that will not reflect adversely on the Eagle Bear Nation or Princess/Guide Program. If a single child left to the supervision of 1 Staff, Parent (participant) that person is required to position themselves to be visible by others. Parents and Volunteers shall never leave a child unsupervised. Staff, Parents and volunteers will portray a positive role model for youth. Staff and/or volunteers may not be alone with children they meet in Eagle Bear programs outside of the Program. As a parent with a child(ren) in the EAGLE BEAR NATION Princess/Guide you are responsible for your child’s supervision and safety during all EAGLE BEAR NATION events/functions. The Eagle Bear Nation Program has zero tolerance for the neglect or the abuse of children. For a complete copy of the Eagle Bear Indian Princess/Guide Program Code of Conduct, or if you have any questions, or see any violations of the above guidelines, please contact Shawn Keil, Volunteer Coordinator. Thank you for working with us to keep all children safe. For more info- please contact your Volunteer Chief or Shawn Keil 772-834-4869 or chiefbutterbean@eaglebearnation.comEVENT/CAMPOUT RULES *I have read Event/Campout RulesSafety is our number one priority. Father or Guardian must supervise their child at all times. All members must follow the rule of three when at events involving restrooms and sleeping quarters. At no time is an adult member to be alone or in a one and one situation with a child other than their own. This is a major violation and will result in immediate termination of the program for the member. Rule of three procedures and training will be discussed at the Chief and Longhouse Meeting along with our Eagle Bear Nation Child Abuse Prevention Training. At any time the Volunteer Coordinator can terminate a membership if the member serves as a safety risk and fails the safety procedure protocols, best practices, and policies of our program without refund. Sling shots, guns (bb guns), shaving cream (of cabins or tents), Atv motorized vehicles, motorcycles, and golf carts are banned from use during all program events. Memberships are non refundable and must be renewed each season. Circle F campout is not refundable unless canceled by the Eagle Bear Program or Circle F. Our Volunteer Coordinator will work hard for you to transfer the credit or give credit to another event if able. Please be advised Circle F requires us to pay before the campout and does not refund Eagle Bear Nation for individual cancellations for the campout and horseback riding. All Campout dates are subject to change from the posted calendar list of events. WAIVER, RELEASE AND INDEMNIFICATION AGREEMENT *I HAVE READ THE WAIVER, RELEASE, AND INDEMNIFICATION AGREEMENTWAIVER, RELEASE, AND INDEMNIFICATION AGREEMENT I HAVE READ AND AGREE TO THE WAIVER, RELEASE, AND INDEMNIFICATION AGREEMENT. In consideration for being permitted to utilize the facilities, services, and programs of Eagle Bear LLC for any purpose—including, but not limited to, observation or use of facilities or equipment, or participation in any program affiliated with Eagle Bear LLC, regardless of location—the undersigned, for himself or herself and any personal representatives, heirs, and next of kin, hereby acknowledges, agrees, and represents that he or she has inspected, or will immediately upon entering or participating inspect and carefully consider, such premises, facilities, or affiliated programs. It is further warranted that entry into Eagle Bear LLC for observation, use of any facilities or equipment, or participation in any affiliated program constitutes an acknowledgment that such premises, facilities, equipment, and programs have been inspected and carefully considered and are accepted as being safe and reasonably suited for the intended purpose. IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER EAGLE BEAR LLC FOR ANY PURPOSE, INCLUDING BUT NOT LIMITED TO OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY PROGRAM AFFILIATED WITH EAGLE BEAR LLC, REGARDLESS OF LOCATION, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING: 1. Release: The undersigned hereby releases, waives, discharges, and covenants not to sue Eagle Bear LLC, its directors, officers, employees, volunteers, coaches, and agents (hereinafter referred to as “releasees”) from all liability to the undersigned, his or her personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claims or demands on account of injury to person or property, or resulting in death, whether caused by the negligence of the releasees or otherwise, while the undersigned is in, upon, or about the premises or any facilities or equipment, or participating in any program affiliated with Eagle Bear LLC, regardless of location. 2. Indemnification: The undersigned agrees to indemnify, save, and hold harmless the releasees from any loss, liability, damage, or cost they may incur due to the presence of the undersigned on the premises, or while observing, using, or participating in any of Eagle Bear LLC’s facilities, equipment, or programs, whether caused by the negligence of the releasees or otherwise. 3. Assumption of Risk: The undersigned assumes full responsibility for and risk of bodily injury, death, or property damage due to the negligence of the releasees or otherwise while in, upon, or about the premises of Eagle Bear LLC, or while using its facilities or equipment, or participating in any affiliated program. 4. USA Lacrosse Membership Requirement: All parents registering their son and/or daughter for Eagle Bear Nation Lacrosse Programs must be active, paid members of USA Lacrosse. An active membership number must be provided to Eagle Bear Nation at the time of registration. The undersigned further expressly agrees that the foregoing Waiver, Release, and Indemnification Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Florida. If any portion of this agreement is held invalid, it is agreed that the remaining provisions shall continue in full legal force and effect.25-26 Eagle Bear Nation Membership *EARLY BIRD SPECIAL – Daddy/Princess or Father/Guide – $149.90Additional Child – $79.90Additional Child – $69.90Additional Child – $59.90Sponsor A Family – $149.90Register your family and sponsor a family! No Family Left Behind! With your generous contributions, we are able to help families that would not otherwise be able to join Eagle Bear Nation.Total$0.00Submit{{#message}}{{{message}}}{{/message}}{{^message}}Your submission failed. The server responded with {{status_text}} (code {{status_code}}). Please contact the developer of this form processor to improve this message. Learn More{{/message}}{{#message}}{{{message}}}{{/message}}{{^message}}It appears your submission was successful. Even though the server responded OK, it is possible the submission was not processed. Please contact the developer of this form processor to improve this message. Learn More{{/message}}Submitting…