I Do hereby:
Give permission to the above student to attend and participate in the Harrison County Sheriff’s Office Summer Camp.
Give permission to the camp staff to render preventative, first aid or emergency treatment, or all of the foregoing, necessary to students' health and well-being. In the event of serious injury/ illness, the need for major surgery, or significant accidental injury, I understand an attempt will be made by the camp staff to notify the designated emergency contacts as soon as possible. If camp staff is unable to communicate with me, the treatment deemed necessary for the students' health and well-being may be given.
Certify that, to the best of my knowledge, the medical information requested above is complete and correct, and that no health-related situations preclude students' participation in camp activities.
Agree to assume all risk arising from campers’ participation in camp activities, including but not limited to any activities that may present risk of bodily injury.
Agree to save, hold harmless, discharge and release HCSO for any and all liability, claims, causes of action, damages or demands in connection with camper participation in camp activities including transportation to, at, or from camp activities.
Understand that any medical expenses for campers’ health and well-being will be the responsibility of the parent/guardian.
Agree to accept any decisions made by the Camp Director in the termination of camp attendance due to unacceptable or unsafe behavior and agree to forfeit reimbursement of any camp fees and pay any associated costs relative to the decision.
Authorize the camp staff to administer medications to my child (as directed by Physician) as indicated on this form.
Consent and authorize the Harrison County Sheriff’s Office to A) use my child’s photograph in their print, online and video publications. 2) Release the Harrison County Sheriff’s Office and its affiliates and employees, from all liabilities or claims that I might assert in connection with the above described activities and 3) waive my right to inspect, approve or receive compensation for any materials or communications, including photographs, videos, or DVD's, website images or written materials, incorporating photos of my child.
Certify that I am the campers parent or legal guardian. On behalf of myself and my spouse, partner, co-guardian, or any other person who claims the participant as a dependent. I have read the above Parental Guardian Release and Information. I understand the contents of this Parental Guardian Release and Information, assent to its terms and conditions, and sign it of my own free act.
Printed Name of Parent / Guardian:
Signature of Parent / Guardian: Date: