Transportation Release. Without limiting Paragraphs
Transportation Release. I understand that, as part of the camp, my child may be transported to different locations in Spokane County. I hereby give permission for my child to be transported for camp activities by modes of transportation determined by camp personnel. By my signature below, I certify I am the legal parent or guardian of the named child, am over the age of 18 and legally competent to sign this form. I certify that I have completely read this document, understand its provisions, and voluntarily accept its terms which constitute legally binding consent, assumption of risk, waiver of claims, and indemnity for participating in EWU Camp Programs. Child’s Name (Please Print) Child’s Date of Birth Parent/Guardian’s Printed Name Parent/Guardian’s Signature / Date Eastern Washington University EWU CAMP PROGRAMS – 2022 MEDICAL, HEALTH INSURANCE, AND CONTACT INFORMATION (for Minors) NOTE: This page is required for minors who wish to participate in EWU Internal Camp Programs. This page is not required for External Camps that are held on the EWU Campus. Camp Name Camp Dates Camper Information (Please print) Name: (first, middle & last) Birthdate: Age: Gender: Email: Mailing Address: City: State: Zip Code: Emergency Contact Information Name: Relation: Alternate Emergency Contact Information Home Phone: Cell Phone: Work Phone: Name: Relation: Phone: Health Insurance Coverage Information Insurance Provider: Policy / ID Number: Subscriber Name: Providers Address: City: State: Zip Code: Health Information Please list any medical conditions your child has that we need to be aware of, including any requiring maintenance medication (e.g. Diabetes, Asthma, Seizures). Medical Problem Required Treatment Should Paramedic be Called? Yes No Yes No Yes No Is your child presently being treated for any injury or sickness, or taking any form of medication that we need to be aware of? Yes No If yes, please explain: Is your child allergic to any type of food or medication? Yes No If yes, please explain: Does your child require a special diet? Yes No If yes, please explain: The purpose of this information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. I certify that the above information is complete and accurate:
Transportation Release. I understand that, as part of the camp, I may be transported to different locations in Spokane County. I hereby give permission to be transported for camp activities by modes of transportation determined by camp personnel. By my signature below, I certify I am over the age of 18 and legally competent to sign this form. I certify that I have completely read this document, understand its provisions, and voluntarily accept its terms which constitute legally binding consent, assumption of risk, waiver of claims, and indemnity for participating in EWU Camp Programs. Participant’s Name (Please Print) Date of Birth Participant’s Signature Date CONSENT, ASSUMPTION OF RISK, WAIVER, AND INDEMNITY AGREEMENT (for Minors) This form is required for minors who wish to participate in an External Youth Camp Program at EWU.
Transportation Release. I understand that, as part of the camp, my child may be transported to different locations in Spokane County. I hereby give permission for my child to be transported for camp activities by modes of transportation determined by camp personnel. By my signature below, I certify I am the legal parent or guardian of the named child, am over the age of 18 and legally competent to sign this form. I certify that I have completely read this document, understand its provisions, and voluntarily accept its terms which constitute legally binding consent, assumption of risk, waiver of claims, and indemnity for participating in EWU Camp Programs. Child’s Name (Please Print) Child’s Date of Birth
Transportation Release. I hereby give permission to authorized representatives of Nugget Surf and its contracted drivers to provide transportation in an authorized vehicle for myself or my child to be transported to and from lessons or practice sessions. I do herby indemnify and hold harmless Nugget Surf and it’s administrators, employees, and persons transporting myself or my child for any claim arising out of injury or accident or incident in the course of providing transportation for myself or my child.
Transportation Release. During the Camp, The Branch has scheduled one or more local off-site field trips to demonstrate architectural and engineering principles in a real-life context. The Branch will transport Camper in a licensed, customary multi-passenger vehicle operated by a licensed and insured driver. Caregiver gives permission for The Branch to transport Camper as part of these Camp activities.
Transportation Release. I understand that, as part of the camp, I may be transported to different locations in Spokane County. I hereby give permission to be transported for camp activities by modes of transportation determined by camp personnel. By my signature below, I certify I am over the age of 18 and legally competent to sign this form. I certify that I have completely read this document, understand its provisions, and voluntarily accept its terms which constitute legally binding consent, assumption of risk, waiver of claims, and indemnity for participating in EWU Camp Programs. ParticiNapmaen(Ptle’asse Print) Date of Birth ParticiSipgnaatnurte ’s Date Eastern Washington University EWU CAMP PROGRAMS MEDICAL, HEALTH INSURANCE, AND CONTACT INFORMATION (for Adults)
