Informed Consent and Acknowledgement
We Hereby Consent
We consent to and authorize All Saints Summer Camp to provide or obtain first aid and medical treatment for our child, whether en route to camp, on the campgrounds, or off the campgrounds, for any routine or emergency situation, including but not limited to injury, illness, choking, or other medical need.
We consent to and authorize All Saints Summer Camp instructors, staff, and other properly trained personnel to provide emergency care, including cardiopulmonary resuscitation (CPR), in the event of a water sports accident or any other situation requiring such care.
If we, the parents or legal guardians, cannot be reached in the event of an emergency or other medical need involving our child, we hereby appoint, authorize, and empower the All Saints Summer Camp Director, Camp Health Officer, Nurse, Doctor, or other duly authorized staff member to act on our behalf as parent or guardian for the purpose of consenting to medical, dental, or surgical treatment for our child(ren) named herein, including authorizing surgery when deemed necessary.
We further authorize any physician, dentist, specialist, other licensed health care professional, hospital, clinic, or other licensed health care facility to provide any and all necessary treatment to our child.
This consent and authorization includes routine care, emergency care, inpatient care, and outpatient care. Any health care professional or facility may rely upon the representation of All Saints Summer Camp staff if we cannot be reached. The original of this form may be presented to the health care provider, but it shall remain in the custody of the Camp Director.
In addition, we agree that, in the event of a health emergency, accident, or any other situation arising while traveling to or from camp or while attending camp, none of the facilitators, staff, or sponsors of All Saints Summer Camp, including but not limited to The Orthodox Church in America, the Diocese of the South, St. Seraphim Orthodox Cathedral, Holy Nativity of the Lord Mission, or any of their staff, volunteers, or representatives, shall be held liable except as otherwise provided by law.
The undersigned acknowledges that participation in All Saints Summer Camp, including activities at Camp Akiva and at other facilities used for supervised camp-related events, involves certain inherent risks and dangers. These may include, but are not limited to, loss of or damage to personal property, physical injury, psychological injury, illness, or death resulting from accidents or other incidents. The undersigned also acknowledges that participants may be transported off camp property for supervised camp-related activities.
In consideration for the right to participate in All Saints Summer Camp, we knowingly and voluntarily assume the risks described above, as well as the ordinary risks incidental to the nature of camp activities, whether or not specifically foreseeable. We agree not to hold liable the Orthodox Church in America, the Diocese of the South, All Saints Summer Camp, St. Seraphim Orthodox Cathedral, Holy Nativity of the Lord Mission, or their clergy, employees, volunteers, agents, or representatives, for claims arising out of ordinary risks associated with participation in camp activities.
We further agree to release, indemnify, and hold harmless the Orthodox Church in America, the Diocese of the South, All Saints Summer Camp, St. Seraphim Orthodox Cathedral, Holy Nativity of the Lord Mission, and their clergy, employees, volunteers, agents, and representatives from and against any and all claims, actions, causes of action, liabilities, damages, costs, or expenses arising out of or related to the participant’s attendance at or participation in All Saints Summer Camp, except to the extent caused by gross negligence or willful misconduct.