ON AND OFF-SITE ACTIVITY RELEASE FORM
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.
Legal Guardian's Information
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.
Camper's Health Insurance Coverage Information: