This part of the application is to be completed and signed by a parent or guardian. Where parents are separated or divorced, this form must be signed by the parent with legal custody as established by a court.
I hereby certify that the above applicant is in good physical health and to my knowledge has no medical and/or physical conditions that would prohibit him/her from participating in any of the activities. I have read all the information in this application and I understand that the camper(s) will be supervised by the camp staff and that if serious injury or illness occurs, medical and/or hospital care will be given.
I further understand that in case of serious injury or illness an attempt will be made to notify the parent or guardian from the information furnished in this form. If it is impossible to reach the parent or guardian, I give my permission for treatment or surgery to be administered as recommended by the attending physician.
I / we acknowledge that the applicant knows and is well aware of the risks and dangers involved in the above Summer Camp Program and are assuming all risks of the injury and damage incidents to his/her participation in the camp. Further, in consideration of the permission granted to the applicant to participate in the BLEND OUT PERFORMING ARTS CAMP 2023, I / we do hereby release and discharge the BLEND OUT PERFORMING ARTS CAMP 2023 and THE BIBLEWAY CHURCH OF ATLAS RD from all claims, demands, actions and causes of action of any kind for any injuries sustained by the applicant and from any damages to applicant and/or applicant’s property as a result of the camp activities which will include, but not be limited to, displays, career-oriented classes, and all summer camp and other recreational activities.