I hereby give permission for my child, (LISTED BELOW) to participate in off-site activities while attending IMPACT CAMP. By signing this form, I agree to hold harmless IMPACT CAMP, its staff, teachers, and volunteers for any accident or injury resulting from my child’s participation. In addition, I agree to assume any and all responsibilities and liabilities with regard to the well being of the child listed below, as well as any financial liabilities or responsibilities incurred from property damage(s) and/or personal injury(ies) directly or indirectly caused by said child. I further give authority during the aforementioned event on this form for the staff, teachers and/or volunteers of IMPACT CAMP to administer, or have administered any and all medical or emergency treatment(s) they deem necessary for the health and well being of said child.
Camper's Information
Camper's Name *
Camper's Name
Legal Guardian's Information
Legal Guardian's Name: *
Legal Guardian's Name:
Legal Guardian's Contact Number: *
Legal Guardian's Contact Number:
Use of BB Guns and Archery Equipment *
By checking the box, I also give permission for my child to participate in the specific activity of target practice using a BB Guns and/or archery equipment. I understand that this activity will be supervised by a responsible adult who has much experience, is trusted by IMPACT CAMP and will enforce strict safety rules throughout the entirety of the activity(s).
Legal Guardian's Signature:
By entering your name in the signature field below you are legally signing this document. This holds the same legal value as would your actual, hand signed signature.
Signature: *
Date Signed: *
Date Signed:
Camper's Health Insurance Coverage Information:
Adult Subscribers Name:
Adult Subscribers Name: