Please mark the severe allergies with an asterisk(*) above.
Please provide an emergency contact for your family. This should be someone not coming to Camp with you who we can contact in the event you are unavailable.
Activities ReleaseI, First Name* Last Name*, hereby acknowledge my willful decision to attend Camp Elim and to participate in all activities. I will not hold Camp Elim or its agents liable for injury caused by common accident, illness (including COVID-19 and any of its variants) or the rendering of emergency care. I give permission for my family members named on this form to participate in any off-site activities during camp and to be transported to and from these activities, including emergency situations (if any) by authorized vehicles.Initial*
Medical ReleaseI, First Name* Last Name*, understand that in the event of an emergency, every effort will be made to contact a responsible relative of the camper. In the event that contact cannot be made, I hereby give permission to the camp administration and the physician they may select to secure proper treatment for, to hospitalize, and to order such injections, anesthesia or operations as may be urgently necessary for myself and my family members named on this form. In the event of a claim, family insurance (if any) will be billed. Camp Elim’s insurance provides secondary coverage for injuries sustained at Camp.Initial*