"My child has permission to attend "identity 2021" with Countryside Baptist Church on the campus of Eagle Rock Retreat Center from June 7th-11th, 2021 and to be transported to and from camp by Countryside Baptist Church bus drivers. I agree to support Countryside Baptist Church in their conduct regulations for my child while at the 2021 Countryside Student Retreat.
I fully understand that injury or illness to my child may result from or during camp participation. In case of a medical emergency, If I cannot be reached, I give permission for my child to be given medical or hospital treatment as deemed advisable for their health and well being. I also give permission for the information provided on this form to be shared with appropriate medical personnel as needed. I agree to the release of any records necessary for treatment, referral, billing, or insurance purposes, and acknowledge that I will be responsible for any medical bills incurred by my child at a local hospital or elsewhere. I also affirm that the medical information on this form is complete and correct.
I hereby agree to release and indemnify the church and its employees, agents, or representatives from any liability associated with my child's participation at teen camp."