Cap Form 31 - Application For Cap Encampment Or Special Activity Page 2
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1
2Name (Last, First, Middle Initial)
Title of Activity
abc
RELEASE BY PARENTS OR GUARDIAN
KNOW ALL MEN BY THESE PRESENTS: WHEREBY my child has applied for the activity or encampment referred to above, In
consideration of the permission extended to my child by the Civil Air Patrol/United States of America through its officers
and agents to participate in said activity/encampment or activities/encampments, I do hereby for myself, my heirs,
executors, and administrators release and forever discharge the Civil Air Patrol, Inc./United States of America, and all its
officers, agents and employees acting official or otherwise, from any and all claims, demands, actions or causes of action,
on account of the death or on account of any injury to my child which may occur as a result of the negligence of the Civil Air
Patrol/United States of America, its agents or employees during said activity/encampment or activities/encampments or
continuances thereof, as well as all ground and flight operations incident thereto. In addition, by my signature below, I
certify the applicant:
1. Is my minor child or ward.
2. Has no history or injury or disease which might be affected by this activity except those previously noted in the Medical
Information section of this form.
3. Will follow all rules, regulations, and directives as established by the Civil Air Patrol, Inc., activity project officer or encampment
commander, or other staff members. If not following the above mentioned rules, regulations, and directives he/she may be sent
home at the discretion of the project officer, encampment commander or activity directory at my expense.
However, in case of injury, disease or other illness, permission is hereby granted to treat the applicant as required, and if
the applicant is released from the activity before recovery from said injury, disease, or illness, further treatment will be
provided by myself.
Date
Witness for Father’s Signature
Father or Legal Guardian
Witness for Mother’s Signature
Mother or Legal Guardian
Squadron Certification. (Squadron Commander’s signature is not necessary if the activity is approved in eServices or if it is
a squadron activity.)
I certify that the above information is correct and that all requirements for attendance, as specified in National
Headquarters Directives, will be completed by the required dates.
Date
Squadron Commander
Group Certification. (Group Commander’s signature is not necessary if the activity is approved in eServices or if the activity
is held within the group.)
Date
Group Commander (or designee)
Wing Certification. (Wing Commander’s signature is not necessary if the activity is approved in eServices or if the activity is
held within the wing.)
Date
Wing Commander (or designee)
CAP FORM 31
REVERSE
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