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Parent Consent – Release Statement
Parent Consent – Release Statement for Camper
Camper Full Name
*
Camp Week Child is Attending
*
Parent Name
*
PLEASE READ AND SIGN. IF UNDER 18, A PARENT OR GUARDIAN MUST READ AND SIGN ALSO.
In submitting this registration, I hereby certify that this camper is in good health and may participate in ordinary camping activities.
I hereby authorize the release of any medical information necessary for insurance purposes to Joy El Camps and Retreats. Joy El will in no way be held responsible for medical treatment or liability resulting from health or physical conditions existing prior to my child coming to camp.
I recognize and acknowledge that COVID-19 is a health threat in our culture at this time and that my child will be interacting with many people at Joy EL. I further agree to indemnify and hold harmless Joy El Camps and Retreats from any claims related to the spread of any infectious diseases including but not limited to COVID-19, my child may receive or carry to another individual at Joy El as a result of attending Joy El’s programs and as such I assume all risk associated with these activities.
In the event of an emergency and you cannot be located and there is a need for the hospital and/or doctor to treat and/or operate, do we have your permission?
Select one
*
Yes
No
I give permission to the camp to provide routine health care, administer prescribed medications, and seek emergency medical treatment including ordering x-rays or routine tests. I hereby give permission for Joy El to administer over-the-counter medications in accordance with Joy El's Health Service Policy by the health care staff. Dosages will be administered according to the directions on the bottle unless a physician directs otherwise. I agree to the release of any records necessary for treatment, referral, billing, or insurance. I am aware that my child may be transported off of camp property for electives or all-camp trips.
I give permission for a spiritual life report to be sent to our church.
I give permission to use photos that include my child in print and internet publicity. I understand that providing my and/or my child's email address gives Joy El permission to send us news and event information by email.
I hereby fully waive, release and discharge Joy El Camps and Retreats, its agents, employees, successors and assigns from any and all rights, claims, and actions arising now and/or in the future, out of my child's participation in camping activities conducted by and/or under the auspices of Joy El Camps and Retreats. I further agree to indemnify and hold harmless Joy El Camps and Retreats from any claims arising out of injury or harm my child may cause to another individual during the course of his/her participation in camping activities. This includes all activities described on brochures and the web page, including but not limited to the Giant Swing, Flying Squirrel, and zip line.
I understand that all registration deposits are nonrefundable.
I also understand that registration fees are nonrefundable within 14 days of any camp event. If a cancellation is necessary in the last 14 days due to illness or accident, a written request to transfer fees to another camp week or event must be submitted within one week of the conclusion of the original week. A note from a physician must be included. Certain restrictions apply and a transfer fee may be charged.
By checking the box below you are signing this document.
I am in agreement with Joy El's parent consent release statement.
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