Columbus Youth Camp
  • Columbus Youth Camp

  • Medical Conditions (include conditions that may affect your participation)

  • Injuries (include conditions that may affect your participation)

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  • Emergency Contact

  • Acknowledgment of Risk and Safety

  • Your signature below verifies that you: 1) Have completed the Health Assessment form to the best of your knowledge; 2) Recognize that there are inherent risks in any outdoor pursuit, and agree to follow instructions and directions given by your leaders, act prudently, use good judgment, and assume a shared responsibility for your safety; 3) Understand that information may be collected and shared for the purposes of demonstrating outcomes or securing funding. 4) Agree that your participation is voluntary, and further agree to indemnify, release and hold harmless the Foundation For Youth, Columbus Youth Camp, its directors, officers and employees from any and all claims or damages for any accident, injury or illness arising out of the use of facilities, equipment and/or participation in Columbus Youth Camp activities; 5) Allow the Columbus Youth Camp Staff to provide routine health care, administer prescribed and parent provided OTC medications, and seek & provide emergency medical treatment where deemed necessary.

  • Clear
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  • Clear
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  • (If participant is under 18 years of age)

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  • Should be Empty: