Sample Camp Release Form printable pdf download

RELEASE FORM

1. M

EDICAL

ELEASE

All information provided on this form is correct to the best of my knowledge. In case of emergency or illness, I understand that

every effort will be made to contact the parent/guardian(s) first and then the Emergency Contact for my child. I give Colorado

Christian Service Camp (Camp Como) permission to seek medical treatment for my child in case of emergency. I give Camp

Como medical staff permission to provide my child with medical treatment which may include, but is not limited to: the use of

acetaminophen (Tylenol), antacids, antibiotic cream, antihistamines (Benadryl, diphenhydramine), ASA (aspirin), Calamine

lotion, Cortaid, Dimetapp, ibuprofen (Advil), insect repellent, Pepto-Bismol, Robitussin, Robitussin DM, sting swabs, Sudafed,

sunburn spray (Solarcaine), sunscreen, or generic equivalents to these medications, physician consultation, urgent, emergent,

and non-emergent medical treatment. I understand that the private health information on this form will only be used and

shared for the purposes of medical treatment. I agree to indemnify and hold harmless Camp Como and its leaders, staff, elders,

employees, members, agents, vehicle owners, vehicle drivers, trip sponsors, board of trustees, and any other parties

volunteering on behalf of the camp from any and all claims, damages, losses, injuries and expenses arising out of or resulting

from my child’s participation in Camp Como activities. Please note any exceptions to treatment:

Signed: _____________________________________________________ Date: ____________________

(Parent/Legal Guardian)

2. W

AIVER AND

ELEASE

I give permission for my child, ___________________________________, to attend and participate in activities sponsored by

Colorado Christian Service Camp (Camp Como). I understand that these activities are at a high elevation, may include physical

activity, and may require transportation. I hereby give my consent for my child to participate in said activities.

3. G

ENERAL AND

OMPLETE

ELEASE

In consideration of my child being allowed to participate in activities sponsored by Camp Como, I do, for myself and on behalf

of my child, release, forever discharge, and agree to hold harmless Camp Como, its leaders, staff, elders, employees, members,

agents, vehicle owners, vehicle drivers, trip sponsors, board of trustees, and any other parties volunteering on behalf of the

camp, from any and all liability, claims, damages, suits, fees, and costs incurred by the undersigned and the child that occur

while the child is at Camp Como participating in any activity that is sponsored by Camp Como.

_________ (Initial)

I realize that my child may incur personal injury or bodily damage while participating in such activities and acknowledge that

many of the activities will be physical in nature and will include travel. I, on behalf of my child, hereby assume all risk of

personal injury, sickness, death, damage, and expenses as a result of participating in all activities involved therein. I

acknowledge that Camp Como, its leaders, staff, elders, employees, members, agents, vehicle owners, vehicle drivers, trip

sponsors, board of trustees, and any other parties volunteering on behalf of the camp, shall be held harmless from any and all

actions, claims, costs, expenses, and damages of any kind, growing out of or related to any activity of the camp in which my

child participates. I further acknowledge that this is a full and complete release for all injuries, sickness, death, limitations, and

damages which my child could sustain as a result of his/her/their participation in any camp activities.

_________ (Initial)

I further agree to hold harmless and indemnify the camp, its leaders, staff, elders, employees, members, agents, vehicle

owners, vehicle drivers, trip sponsors, board of trustees, and any other parties volunteering on behalf of the camp for any and

all liability sustained by the church and camp as the result of the negligent, willful or intentional acts of my child, including

expenses incurred. _________ (Initial)

Rev. 2/15

Sample Camp Release Form

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