2025 TEEN REACH ADVENTURE CAMP

QUESTIONS?

If you have questions or concerns about TRAC Ocala please contact our volunteer TEEN Placement Coordinator or Camp Director Tiffany Bagasan at director@sharetheloveocala.com

You will be contacted by our TEEN Placement Coordinator who will talk to you futher about this application once submitted.

PERMISSION TO ADMINISTER

OVER-THE-COUNTER MEDICATIONS

I give Teen Reach Adventure Camp (A program of Share The Love Ocala) Registered Nurse permission to administer the following products according to manufacturer’s instructions, or/as otherwise specified.  TRAC Registered Nurse has permission to provide any of the following that is/are needed:

Sunblock
Insect Repellent
Lip Balm
Rash Ointment
Tylenol
Antiseptic Ointment
Band-Aids
Anti-Itch Cream
Hydrogen Peroxide
Cough Syrup
Cough Drops
Decongestant
Antihistamine
Ibuprofen

MEDICAL PERMISSION:

This health history is correct so far as I know, and the above named minor has permission to engage in all prescribed program activities, except as noted. The undersigned do hereby authorize the directors of Teen Reach Adventure Camp, or such substitute as they may designate, as agent for the undersigned to consent to: X-Ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care for the above minor, which deemed advisable by, and to be rendered under the general or special supervision of any physician and surgeon, licensed under the provision of the Medicine Practice Act or any dentist licensed under the Dental Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, camp or elsewhere. This authorization will remain effective while the above minor is en-route to and from camp, involved or participating in any camp program, unless revoked in writing by the undersigned and delivered to the Director of Teen Reach as legal guardian/social worker/other. My permission is given for the minor named in this application to attend Teen Reach Adventure Camp in the summer of 2025 through Share The Love Ocala.

PERMISSION TO TRANSPORT:

The above-mentioned organizations, are hereby authorized to transport said minor by bus from the registration location in Ocala, FL to the campground, and transport the minor from the campground to the pick-up location in Ocala, FL. I understand that if I should, for any reason, desire to retrieve said minor from camp before last day of camp, I will first be required to make arrangements with the directors and meet at an agreed upon location. By my signature, I release Good News Church, Share The Love Ocala, Teen Reach Adventure Camp Inc, and any other involved parties from liability in relation to travel to and from camp.

WAIVE, RELEASE AND DISCHARGE:

In consideration of my application and permitting my child to participate in this activity, I hereby:

WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of Share The Love Ocala, its officers, employees, volunteers, entities or other persons released, for my child’s death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to them including their traveling to and from this activity; INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE Share The Love Ocala, its officers, employees, volunteers, or other entities or persons released from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

I understand that while participating in this activity, my child may be photographed. I agree to allow their photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns.

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. Share The Love Ocala, it’s directors, officers, and all its employees, and volunteers acting officially or otherwise are hereby released from any and all claims, demands, actions, or causes of action on account of any injury to my child that may occur. This release binds my heirs,executors, administrators, and/or assigns.