CAMPER WAIVER AND RELEASE FORM Camper's Name * First Name Last Name EMERGENCY MEDICAL AUTHORIZATION I, the undersigned parent or legal guardian of the above-named minor, know that I may not be available to authorize medical care of said minor child and I wish to appoint Creative Breaks Children’s Enrichment Camps to act in my place in my absence and to give such authorization. This authorization is intended to give Creative Breaks Children’s Enrichment Camps the right to give consent to authorize emergency medical care. Parent/Guardian Electronic Signature * Today's Date * MM DD YYYY PHOTO RELEASE The parent of a the above named child at Creative Breaks Children’s Enrichment Camps, agree to the following:I understand that my child who I am completing this registration form for may be photographed at camp during normal camp activities. I understand that these photographs may be used in promoting Creative Breaks Children’s Enrichment Camps services, either in print or on the Internet. I understand that it is my responsibility to update this form in the event that I wish to authorize or to not authorize the above uses. I agree that this form will remain in effect during the term of my child's enrollment. I understand that there will be no payment for me or my child's participation in this release. With My Signature Below * I Grant Permission I DO NOT Grant Permission Parent/Guardian Electronic Signature * Today's Date * MM DD YYYY SUNSCREEN AUTHORIZATION I will provide my child with his/her own sunscreen with a minimum of SPF 30. Sunscreen will not be applied to any broken skin or if a reaction has been observed. Any reaction observed by staff will be reported to the parent/guardian. Select One * My child will be responsible for applying sunscreen to exposed skin surfaces, prior to sun exposure. The staff of Creative Breaks Children’s Enrichment Camps may assist my child in applying sunscreen to exposed skin surfaces, prior to sun exposure. Parent/Guardian Electronic Signature * Today's Date * MM DD YYYY GENERAL PARTICIPATION RELEASE I hereby consent to the child's participation in the activities that are described to me in the registration process. I understand that activities of the kind described may result in physical injury to my child but nonetheless specifically request that he or she be allowed to participate in those activities. I, the parent/guardian, hereby agree and declare that I have carefully read and understand the scope of the summer camp activities and I consent to the participation of the above-named child to participate in these activities. Any type of injury that may occur to the child without the fault of the camp management and activity supervisors, the camp management cannot be held responsible for any harm that may occur to the child without the fault of the camp management and activity supervisors. Parent/Guardian Electronic Signature * Today's Date * MM DD YYYY Thank you! Please do not hesitate to contact us with any questions that you may have.
