• Individual Release and Understanding 2025

    You must be 18 years of age or older to fill out this form. One form per attendee. A parent/guardian must complete and sign this form for their camper under 18 and include their contact phone and email as the emergency contact information.

  •  -

  • Please enter an Emergency Contact who will NOT be at Camp during this retreat.

  •  -

  • Consent to Release & Understanding

    Indicate your consent to each item below.

  • Activities Release
    I,   *   *, hereby acknowledge my willful decision to attend Camp Elim and to participate in all activities. I will not hold Camp Elim or its agents liable for injury caused by common accident, illness (including COVID-19 and any of it's variants) or the rendering of emergency care. I give permission to participate in any off-site activities during camp and to be transported to and from these activities, including emergency situations (if any) by authorized vehicles.
    *

  • Activities Release
    I,   *   *, hereby give permission for my child {campersName} to attend Camp Elim and to participate in all activities. I will not hold Camp Elim or its agents liable for injury caused by common accident, illness (including COVID-19 and any of it's variants) or the rendering of emergency care. I give permission for {campersName} to participate in any off-site activities during camp and to be transported to and from these activities, including emergency situations (if any) by authorized vehicles.
    {campersName} to attend Camp Elim and to participate in all activities. I will not hold Camp Elim or its agents liable for injury caused by common accident, illness (including COVID-19 and any of it's variants) or the rendering of emergency care. I give permission for {campersName} to participate in any off-site activities during camp and to be transported to and from these activities, including emergency situations (if any) by authorized vehicles., Initial here" />*

  • Medical Release
    I,   *   *, understand that in the event of an emergency, every effort will be made to contact a responsible relative. In the event that contact cannot be made, I hereby give permission to the camp administration and the physician they may select to secure proper treatment for, to hospitalize, and to order such injections, anesthesia or operations as may be urgently necessary for me. In the event of a claim, family insurance (if any) will be billed. Camp Elim’s insurance provides secondary coverage for injuries sustained at Camp.
    *

  • Medical Release
    I,   *   *, understand that in the event of an emergency, every effort will be made to contact a responsible parent or guardian of {campersName}. In the event that contact cannot be made, I hereby give permission to the camp administration and the physician they may select to secure proper treatment for, to hospitalize, and to order such injections, anesthesia or operations as may be urgently necessary for {campersName}. In the event of a claim, family insurance (if any) will be billed. Camp Elim's insurance provides secondary coverage for injuries sustained at Camp.
    {campersName}. In the event that contact cannot be made, I hereby give permission to the camp administration and the physician they may select to secure proper treatment for, to hospitalize, and to order such injections, anesthesia or operations as may be urgently necessary for {campersName}. In the event of a claim, family insurance (if any) will be billed. Camp Elim's insurance provides secondary coverage for injuries sustained at Camp., Initial here" />*

  • By entering your name below and submitting this form you agree to the terms of this release.

  • Clear
  •  - -
  • Should be Empty: