*CONSENT OF PARENT OR GUARDIAN FOR MEDICAL TREATMENT: I am the parent or guardian having legal custody of the child named above. I authorize all medical, surgical, diagnostic, and hospital care or procedures which may be performed or prescribed for my child by a licensed physician or hospital, when efforts to contact me are unsuccessful and when deemed immediately necessary or advisable by the physician to safeguard my child’s health. I waive my right of informed consent to such treatment. I will take full responsibility for all charges that occur. Girl Scout insurance is secondary to your primary insurance.
*I know of no reason (s), other than the information indicated on this form, why my child should not participate in activities except as noted.
*I have reviewed the Girl Scouts of Western Washington policy on administering medication to a minor. If applicable, I will take with the camp director about any medication my child needs during the day and I will complete the appropriate permission forms.
* I agree to instruct my child to observe rules and regulations governing the activities. I understand camping programs involve inherent risks and possible injury because of the nature of the activity, even when conducted in a safe manner. I give permission for my child to attend camp and participate in all phases of the program including off-site activities and related transportation. I understand my child’s good health is required before she can attend camp.
*The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact, by contact with contaminated surfaces and objects, and possibly in the air. People reportedly can be infected and spread the disease even if they do not show any symptoms. Girl Scouts of Western Washington (“GSWW”) is committed to taking precautions to mitigate that risk as well as to following applicable federal, WA State, local and GSUSA COVID-19 directives and guidelines. Our council is also committed to having in-person activities as allowed and in accordance with those mandates. GSWW’s operations and programs occurring while COVID-19 is circulating in our community may expose our members, volunteers, and employees to the risk of infection. GSWW cannot prevent you from becoming exposed to, contracting or spreading COVID-19 while attending (which includes being present in any capacity) any GSWW in- person programming. Therefore, any interaction with others in connection with in-person programming may expose you and your family to and increase your risk of contracting or spreading COVID-19. GSWW has put in place preventative measures to reduce the spread of COVID-19 at its inperson programming; however, GSWW cannot guarantee that you will not become infected with COVID-19.
By participating in these in-person activities, participants will be viewed as:
1.) Understanding that COVID-19 is a highly contagious virus, easily spread including through in-person contact;
2.) Acknowledging that GSWW cannot guarantee that infection will not occur;
3.) Choosing to accept the risk of contracting COVID-19 for the participant and their family in order to attend the inperson activity; and
4.) Agreeing to release GSWW from responsibility in the event of COVID-19 infection. Participants who do not agree to these statements should not join in-person GSWW activities.
5.) I understand, as a camp attendee, I will be “Girl Scout Ready”, pursuant to the Girl Scout Ready self-screening tool, 30 minutes prior to camp, and will not attend camp and immediately inform the Camp Director if I am not “Girl Scout Ready”
PLEASE REVIEW AND BECOME FAMILIAR WITH THE "GIRL SCOUT READY SELF-SCREENING TOOL" AT THIS LINK.