YFC CAMP

Non-Prescription Medications: The following non-prescription medications may be used on an as needed basis to manage illness and injury. Please indicate below which medications the participant may NOT receive. These non- prescription medications will be administered by YFC staff according to manufacturer's labeled dosages unless a written statement (prescription) from participant's health-care provider authorizes a different dosage.

All non-prescription medications need to be turned in to the camp nurse upon arrival. The nurse will administer medication as needed. Medications will be returned upon departure.

Medication Administration Instructions: "If medicine is present during YFC activiteis, that medicine must have written instructions present with it during the activity from a doctor, parent, or legal guardian."

Any medication, prescription or over-the-counter, brought to a YFC activity must have written medical instructions and dosage information from a physician, parent or legal guardian. All medications must be in the original container when issued.

Please describe all the details of dosing and administering prescription meds, non-prescition meds, and/or nutritional supplements the particiapant is bringing with them, as well as any drug interactions that you are aware of with these medication prescriptions.

I herby request that my child is to receive a modified diet as prescribed by his/her physician

Permission to participate- Recognize accidents may happen when doing fun stuff and accept risks- Choose to come healthy- Hold YFC harmless- Consent to emergency medical treatment and costs- Media release- Behavior agreement for safety

1. RELEASE OF LIABILITY- “I give my permission to participate in YFC activities. I understand accidents can happen when doing fun activities and accept the risks. I or my child agree to come to YFC activities healthy." 
I understand that the opportunity to participate in YOUTH FOR CHRIST/USA, INC., et al ("YFC") activities is a privilege. I am signing this Release Liability form on behalf of myself or my minor child. I understand that my child may participate in any number of physical activities some of which include, but are not limited to, recreational activities and games and events. I understand that there are certain risks of physical injury or illness associated with these activities. In addition, I understand that there may be other risks associated with activities of which may not be presently aware.

By signing this Release, I expressly assume these risks for myself or my minor, whether they are known or unknown to me at this time, and certify that I or my child is healthy and fit to participate in all YFC activities. I release YOUTH FOR CHRIST/USA, INC., including its affiliated chapters, affiliates, and their officers, directors, volunteers, employees, contractors and agents, from any claim that I or my child may have now or in the future against them for any accidental physical or other personal injury, loss of personal property, illness or death caused by infectious and/or contagious diseases or sickness while at camp or other YFC activities, or during YFC travel to and from camp or other YFC activities, and any medical responses to the same, as well as any other claims arising from participation in YOUTH FOR CHRIST/USA INC. et al activities. This release of liability shall cover (without limitation) all claims for negligence and breach of fiduciary duty asserted by my child, myself or any person made on their behalf. This Release specifically covers claims caused in whole or in part by any U.S. national health crisis, epidemic, pandemic, or similar widespread outbreak of disease whether or not such is formally declared by the U.S. government, the Center for Disease Control or the World Health Organization YFC reserves the right to follow recommended CDC guidelines related to such pandemic, outbreak or disease and as such may choose at any time to send a participant home if presenting signs of sickness.

2. INDEMNIFICATION - “I agree to hold YFC harmless.”

I hereby agree to defend, indemnify and hold YOUTH FOR CHRIST/USA, INC., including its chapter affiliates, their directors, volunteers, employees, contractors and agents, harmless from any liability asserted by me or my child subsequent to his or her 18th birthday, including reasonable attorney's fees and costs.

3. AUTHORIZATION FOR MEDICAL TREATMENT- "If an accident happens and if cannot be reasonably reached, I give permission for emergency medical treatment and promise to cover medical costs if treatment is needed."

I understand it may be necessary to have a medical consent form present for medical professionals in the unlikely event of an injury or condition requiring medical treatment of me or my child. This form gives YFC and its personnel the permission to take me or my child to the nearest, capable medical facility and have any necessary emergency treatment administered

IF PARTICIPANT IS A MINOR: IN CASE OF EMERGENCY, I UNDERSTAND THAT EFFORTS WILL BE MADE TO CONTACT ME; HOWEVER,IF I CANNOT BE REACHED, I THEREBY GIVE YOUTH FOR CHRIST/USA, INC. AND ITS REPRESENTATIVES THE PERMISSION TO ACT ON MY BEHALF FOR MY CHILD'S HEALTH, SAFETY AND WELFARE. I GIVE PERMISSION TO THOSE ADMINISTERING MEDICAL TREATMENT TO DO SO, USING THE MEASURES DEEMED NECESSARY. I RELEASE YOUTH FC CHRIST/USA, INC., ITS REPRESENTATIVES, AND ALL MEDICAL PROVIDERS FROM LIABILITY IN ACTING IN THIS REGARD AND RENDERING SUCH MEDICAL TREATMENT. I WILL BE FULLY RESPONSIBLE FOR ALL SUCH MEDICAL EXPENSES SEEKING EMERGENCY MEDICAL TREATMENT FOR MY CHILD IN THE EVENT THAT SUCH TREATMENT IS DEEMED NECESSARY OR ADVISABLE

IF PARTICIPANT IS 18 OR OVER: IN CASE OF EMERGENCY, AND AM UNABLE TO REPRESENT MYSELF, THEREBY GIVE YOUTH FOR CHRIST/USA, INC. AND ITS REPRESENTATIVES THE PERMISSION TO ACT ON MY BEHALF IN SEEKING EMERGENCY MEDICAL TREATMENT FOR MY PERSON IN THE EVENT THAT SUCH TREATMENT IS DEEMED NECESSARY OR ADVISABLE FOR MY HEALTH, SAFETY AND WELFARE. I GIVE PERMISSION TO THOSE ADMINISTERING MEDICAL TREATMENT TO DO SO, USING THE MEASURES DEEMED NECESSARY. I RELEASE YOUTH FOR CHRIST/USA, INC., ITS REPRESENTATIVES, AND ALL MEDICAL PROVIDERS FROM LIABILITY IN ACTING IN THIS REGARD AND RENDERING SUCH MEDICAL TREATMENT. I WILL BE FULLY RESPONSIBLE FOR ALL SUCH MEDICAL EXPENSES

4.MEDIA RELEASE- "YFC can use pictures and other media of me or my child participating in YFC activities for promotional purposes”

I hereby grant permission to YOUTH FOR CHRIST/USA, INC. the right to use, reproduce, and/or distribute any photographs, film, video and sound recordings of me and my child, without compensation or approval rights, for use in materials created for purposes of promoting the future activities of YOUTH FOR CHRIST/USA, INC.

5. BEHAVIORAL AGREEMENT - "YFC hates sending participants home, but sometimes they have to. I recognize that.”

I understand that illegal, immoral activity, or behavioral issues may result in the named participant being sent home at the expense of the parent/guardian. Activities would include but are not limited to: reasonable belief of possession and/or use of drugs, alcohol, weapons; sexually aggressive and/or inappropriate behavior; stealing; fighting: etc. YFC leaders will make reasonable effort to contact the parent/guardian to make arrangements before a participant is sent home

I have read the above waivers/releases and understand what I have read.

I represent that I am the participant named below (if 18 or over) or the legal parent/guardian of the child named below, who is under 18 years of age. In consideration for allowing my child to participate in this activity and ongoing YFC activities, I hereby consent to the foregoing on behalf of my child and agree that this release shall be binding upon me, my child, our heirs, legal representatives and assigns.