Lech-Lecha לך-לך

Health Forms and Waivers Packet

Medications

• All prescription medications must include a pharmacy label, be unexpired and in original containers.
• List all medication needed during camp hours, include over-the-counter medications.

I understand that for any prescribed medications, or over-the-counter medication not listed above, to be administered by the camp staff, an authorization form from the camper’s own doctor will need to be completed.  I further understand that all medications, both prescribed and over the counter, are required to be in the original container.  This requirement covers vitamins and homeopathic remedies.

Please download the form HERE, have your physician fill it out, and return it to us via the form below.

I HAVE READ THIS WAIVER, RELEASE AND ASSUMPTION OF RISK AND, INTENDING TO BE LEGALLY BOUND BY IT, I HEREBY EXECUTE THIS RELEASE.

Permission and Release Form

Please read carefully and sign below.

If my child attends Lech-Lecha Adventure Camp, I agree to:

• Allow my child to participate in all Explore ~ Lech Lecha activities including but not limited to arts, athletic games, swimming, hiking, team-building activities, and special events.
• Send necessary medication (if my child requires medication).
• Authorize any social service agencies, schools, clinics, or doctors or other medical professionals holding information with respect to my child to release information to the camp director or staff, which the camp director or staff feel is necessary to care for my child at camp.
• By signing this form, I hereby release and hold harmless Explore ~Lech Lecha, its directors, officers, employees, contractors, agents, and representatives (including, for the avoidance of doubt, the camp staff) from any and all damages, claims, injuries, and liabilities of whatever kind, including but not limited to claims for bodily injury or loss or damage to personal property, which may arise out of my child’s attendance at camp and out of his/her participation in any activities while in attendance, including any
  illness, injuries, or other damages, claims or liabilities of any kind related to exposure to COVID-19. I acknowledge that this summer in particular an inherent risk of exposure to COVID-19 exists in any place where people are present, and voluntarily assume all risks related to exposure to COVID-19.
• My child has active medical insurance throughout my stay at Explore ~ Lech Lecha and I have provided Lech-Lecha with that information.
• I give my permission for Lech-Lecha to:Have and use photographs, slides, videotapes or other media of my child participating in camp activities,
  for its records, public relations (i.e., brochures, website, newsletters, and presentations) or promotion of camp.
  I understand and acknowledge that: If my child comes to camp without necessary medication in original containers, he/she will be sent home.
• There is inherent risk involved in the outdoor and active Camp program that my child will participate in at Lech-Lecha, including (but not limited to) risks relating to COVID-19.
• Lech-Lecha reserves the right to send my child home who displays a pre-existing medical or behavior condition not disclosed prior to the start of camp, at the sole discretion of the camp director.
• Lech-Lecha reserves the right to make the determination when or if it may be necessary to have a child withdrawn from the program and to withhold all fees should withdrawal be for purposes of maintaining the welfare or safety of the child or other program participants.
• If the Camp determines that my child needs to be returned home for any reason, I agree to provide transportation as soon as it is needed.
• I will be available for the duration of my child’s stay at camp in case I need to be reached in an emergency.

By signing this form, I hereby indemnify, release, hold harmless and covenant not to sue Lech-Lecha, its directors, officers, employees, contractors, agents, and epresentatives.  I hold Lech-Lecha harmless from any and all damages, claims, injuries, and liabilities of whatever kind, including but not limited to claims for bodily injury, death and/or loss or damage to personal property, which may arise out of my retreat attendance and out of my participation in any activities while in attendance, including any illness, injuries, or other damages, claims or liabilities of any kind related to exposure to COVID-19.  I acknowledge that this summer in particular an inherent risk of exposure to COVID-19 exists in any place where people are present, and voluntarily assume all risks related to exposure to COVID-19.

I have carefully read this waiver, release and assumption of risk, fully understanding its contents, voluntarily sign it and realize that it will bind me, my heirs, and my personal representatives.