Parent Authorization/consent Form
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1UAF Youth Adventure Camps
PARENT AUTHORIZATION/CONSENT FORM
Child’s Name:
Telephone:
Parent’s Name:
Day phone:
Cell:____________________
Parent’s Name:
Day phone:
Cell:____________________
If not available in an emergency, please notify:
Name
Relationship
Phone
Name
Relationship
Phone
Authorized pick-up people are: (including parents)
1.
2.
3.
4.
5.
6.
In the event of any emergency and someone not listed must pick up your child, please call the SRC
474-5886 and inform the DIRECTOR. Please do not send anyone to pick up your child whom your child
will not recognize.
Authorization for my child to walk/bike home
My child has permission to leave the UAF Youth Adventure Camp site and walk/bike home without adult
supervision. I understand that UAF and its staff are not responsible for my child’s safety after this time.
Walkers/ bikers are not to leave the SRC before 4:00pm unless a signed note has been sent by the parent.
Parent/Guardian Signature:
Date
Field Trip Consent
I/We give permission for my/our child to attend camp and participate in all phases of the UAF Recreational
Camp program including off-campus field trips when they apply. Weekly field trips include climbing,
canoeing, kayaking, hiking as well as the transportation to and from those sites. I understand that the staff
will exercise reasonable care to ensure my child’s safety. Adults accompanying the group will provide
supervision and will exercise reasonable care to avoid accidents. By signing below I am granting my child
permission to attend weekly field trips and agree to the terms discussed above.
Parent/Guardian Signature:
Date
Parent’s/Guardian’s Consent
I/We have read and understand the information presented in this packet. I/We are aware
and understand
that the activities included during the UAF Youth Adventure Camps (including climbing, hiking, rafting,
and other activities) involve inherent risks and may result in personal injury or death. I/We agree to
cooperate with all camp procedures and regulations. My/Our child may be photographed and pictures
released for publicity. I/we are fully informed about the risks associated with participation in the activities
and consent to our child’s participation in the UAF Youth Adventure Camp.
Parent/Guardian Signature:
Date
4.6.12
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