Medical Historyadf Form
  • Camper Health Form

  • Information

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  • Emergency Contact Info

  • Health Insurance Info

  • Camper Medical Info

  • Consent to Treat Agreement

  • Pursuant to the Family Rights and Responsibilities Act and Tenn.Code Ann. §63-1-173(c)(1). The Fort Bluff Camp nurse staff need permission to care for your camper as follows: 

    -To render aid and to treat any non-emergency health conditions such as stomachache, headache, vomiting, cuts and abrasions, nose bleeds, etc 

    -To render aid and to treat any emergency health conditions such as allergic reactions, serious wounds, or injuries, etc. 

    - To dispense over-the-counter medication as may be required to treat the camper. 

    -To follow medical orders received from treating physicians or other health care professionals. 

  • I understand that, if I give consent, then I have the right to revoke consent at any time upon informing Fort Bluff Camp office in writing. 

    I also understand that, if I withhold or revoke consent, then I agree that I will come to campus immediately to care for my camper myself. I also understand that the camp nurse staff and camp leadership, in their discretion, may call 911 to deal with any emergency and that if they do, then I will be responsible for any charges. 

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  • Liability Wavier Agreement

  • I/We agree to hold the NACA/Fort Bluff and its agents harmless of any liability resulting from injuries or loss of property sustained by me/our child during any tournament/camp/retreat function. I/We give consent for me/our child to receive medical treatment by a registered nurse or licensed physician when deemed necessary by the Camp Leadership. I/We understand that Fort Bluff does not provide any form of accident or sickness medical benefits, including insurance coverage for me/my child while I/my child am (is) participating in Fort Bluff activities or on Fort Bluff premises. I/We agree that I/We are responsible for all medical expenses incurred from injuries/illnesses that I/my child might sustain. I understand that as a participant, I or my child may be photographed or videotaped during normal camp or event activities, and these photos/videos may be used in promotional material.

    I will contact Fort Bluff Camp in the event of a cancellation and agree to abide by Fort Bluff cancellation policy. Cancellation Policy - 4 weeks prior 100% refund, 3 weeks prior 75% refund, 2 weeks prior 50% refund, 1 week prior 25% refund. Fort Bluff reserves the right to cancel any and all events, camps, retreats, and/or tournaments due to circumstances beyond our control, which include, but are not limited to: natural disasters or other unusual weather events often termed Acts of God, travel restrictions instituted by public officials, widespread pandemic occurrences, or any event that may significantly impact Fort Bluff’s ability to properly conduct an event, camp, retreat, and/or tournament. If Fort Bluff cancels an event, camp, retreat and/or tournament, Fort Bluff will work with registered participants to arrange refunds and/or future credits. If any of the above-mentioned occurrences causes a registered participant to drop-out, not attend, or cancel their participation the refund schedule outlined above will be used to determine possible refunds.

    Any cancellation by a registered participant for any reason less than seven-calendar days prior to on-site registration for an event, camp, retreat and/or tournament will be submitted to our registration appeals committee for review. The decision of the registration appeals committee regarding refunds will be final.

    I agree to have my child to abide by the rules and guidelines set forth in the Planning Packet; I am responsible for the actions and attitude of my child. If there are any repeated infractions, I realize it could jeopardize our returning to NACA/Fort Bluff Camp in the future.

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