Acceptance Of Event Conditions: I understand and agree to the conditions of the event venue as described in the information provided. I give permission for my child to participate under these conditions.
Disclosure Of Special Health Conditions: The following is a list of my child’s special health conditions and needs of which event staff need to be aware. (List below such things as medications, history of seizures, motion sickness, allergies, Etc)
Release of liability regarding special health conditions: I submit that the above-mentioned special health conditions and instructions are needed for my child while at the event. I understand that, although event Personnel will seek to help accommodate these special conditions, such as by giving medications and or by seeking to take appropriate precautions, Etc., nonetheless by sending my child to the event with the special health conditions:
I acknowledge that I understand the event is not equipped to monitor or supervise such special conditions or needs as would the parent if he / she were present.
I certify it is safe for my child to participate and all event activities notwithstanding the special conditions, and notwithstanding any possible laps in medication, or possible interaction with other people or circumstances that may affect the special conditions.
I release and indemnify the event from all claims and liability stemming from the special conditions, including, without limitation, any claim, illness, or injury. Resulting from the events failure to properly administer medicines for the special conditions. Failure to recognize a situation which might be potentially harmful to a person with the special condition, or failure to recognize the onset of an episode of the special conditions.
Permission to secure Emergency Services: I give permission to the event staff to secure usual and customary medical and or legal services for my child if needed in an emergency circumstance at the event. I as Parent / Guardian will be responsible for the cost of such Services if not covered by my insurance.
Christi Johnson: 662-444-8505Brandon Antwine: 225-354-5766
Note. If a parent would feel more comfortable having their child bring a cell phone to camp for safety reasons, please say “yes” in the box below: