Permission is requested for the child indicated at the top of this form to participate in group activities at Camp Good Mourning, a program sponsored by Altru Health System. The day camp is designed to include movement, music, creative writing, drawing, artistic activities, and discussion of your child’s feelings and opinions. Some of what will be covered includes:
- Using creativity to help children cope with loss and grief
- Communication and expression of feelings of loss and grief
Children will have the opportunity to learn new coping skills that may help their development and adjustment during this time of grief.
Because Camp Good Mourning is based on trusting relationships, the leaders will keep the information shared by participating students confidential—except in certain situations where there is an ethical obligation to break confidentiality for the safety or wellbeing of the child.
I give my informed consent for my child to participate in Camp Good Mourning.
I give permission for my child to be photographed during the camp at appropriate times. These photos may be shared with program sponsors who may or may not use the pictures later, while still protecting the identity of my child.
I also understand my child will be taking part in physical activities that can result in risk of physical injury to my child. I therefore release and discharge all liability for any harm or injury suffered directly or indirectly as a result of my child’s participation in Camp Good Mourning.