Participant Information & AgreementParticipant Information & Agreement • December 3rd, 2014
We operate in remote locations where access to medical care can sometimes be difficult or delayed. Completing this questionnaire fully and accurately will give our staff an understanding of your abilities and possible limitations. This information will remain confidential, with the exception of any medical history or allergy information which may put the group or you at risk if it is not disclosed. We will release only the information required for this purpose. In the unlikely circumstance that other information may need to be released, we will do so only with your permission.
Participant Information & Agreement for the Cool Runnings Track Club (rev. 4/2012)Participant Information & Agreement • April 24th, 2012
Name of participant: Name of participant: _ Name of participant: Name of participant: Name of participant: Name of participant:
Camp Hanes Paintball Participant Information/AgreementParticipant Information/Agreement • March 17th, 2011
YMCA Camp Hanes is not making a determination of a participant’s fitness for an event; rather, the participant represents to YMCA Camp Hanes and verifies that they are physically fit and ready for an event. It is important to discuss all medical conditions and/or physical activity concerns with a YMCA Camp Hanes Staff member prior to participation in all activities. All information given will be held in strict confidence. I understand and acknowledge that my failure to disclose relevant information may result in harm to myself/my child and/or others during an event. I represent and warrant that I have provided all materials and important information to YMCA Camp Hanes pertaining to my medical, mental and physical condition related to my participation. Medications (prescribed or over the counter) arriving with participants must be in original pharmacy labeled containers and kept with the group leader. YMCA Camp Hanes staff is not permitted to administer any medications.
