CCA Summer Camp Registration Form

Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Cresset Christian Academy during the selected camp. In exchange for the acceptance of said child’s candidacy by Cresset Christian Academy, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Cresset Christian Academy and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Cresset Christian Academy including all staff and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Medical Release and Authorization As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named camper. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to CCA Summer Camp and its affiliates including directors, staff and volunteers to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release is authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

By signing, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical treatment for the above named camper by authorized personnel. I understand that the above named camper will only be released to the parent, guardian or authorized pickup names listed above (an update may be completed at registration). I certify that my child has my permission to attend camp and participate in all activities. *

Type first and last name above to consent

Sign Form*

Date Signed*

MonthDayYear

Camp Director Name and Contact Info

CCA Summer Camp Registration

Camper's Information

Parent/Guardian Information

Parent/Guardian Information

Emergency Contacts/Authorized Pickup

Emergency Contact/Authorized Pickup

Emergency Contact/Authorized Pickup

Medical / Health Information

Medication Administration at Camp

Consent and Acknowledgement

Payment and Statement of Understanding