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Consent for Camper to attend Camp Connections
I/We_______________________, am/are the legal guardian of _____________________ Social Worker / Parent(s) child’s name
o I/We authorize the camper named above to attend Camp Connections o I/We authorize Camp Connections staff to perform CPR or minor first aid treatment if required. o I/We do not hold Camp Connections responsible for any lost or stolen items, or hold Camp Connections liable in the event of any accident or injury. In the event of an emergency, campers will be transported to Stanton Territorial Hospital and the on call social worker as well as the foster parents, or otherwise legal guardian will be notified immediately.
This Consent is in effect from ___________ to ___________ Dated this ________day of _________, 2008 Signed,
_________________________ ___________________________ Signature of Legal Guardian Print name and title
MEDICATION/VITAMIN RECORD
NAME OF CAMPER: _______________________________________
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