I hereby certify that the above-named camper is in good physical health and subject to the camp rules and regulations.
Parent/Guardian grants full permission to YMCA Camp Pendalouan to use any photograph, video tape, film, or motion picture of camper and/or family in promotional materials.
I understand that there are certain risks involved in camping activities. By signing below, I agree to defend, indemnify and hold harmless YMCA Camp Pendalouan / the Muskegon Family YMCA, it’s officers, employees, and representatives from and against any and all liability, loss, damage, injury, or death arising from acts connected with any camp activities, use of facilities and equipment, or interaction with any campers or staff. YMCA Camp Pendalouan reserves the right to cancel any program scheduled or currently in progress at camp.
Permission to Provide Necessary Treatment or Emergency Care:
I hereby give permission to the medical personnel selected by the camp director to order x-rays, routine tests, treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary transportation for me/or my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director to secure and administer treatment, including hospitalization, for the person named above. The completed form may be photocopied for trips out of camp.
For the camper listed on this form, within 48 hours of arrival to camp, I have or will have inspected his or her head for lice and belongings for any insect infestations and will not allow her or him to attend if so infected.