By typing in your name below (in the format: /s/John Smith), you are acknowledging that you are the parent/guardian of above named child and that you acknowledge that you have read and understood the information set forth below, including the release and hold harmless agreement.
1. ACKNOWLEDGEMENT OF INHERENT RISKS
I give my child/ward permission to attend Camp McCullough and to participate in scheduled and unscheduled activities. I have read and understand the risks, and responsibilities, and liabilities as listed below. I certify that I am aware of the inherent risks associated with outdoor camp activities as well as the inherent risks of being on camp property, notwithstanding, I hereby give my child/ward permission to participate in all camp activities. Camp activities may include but are not limited to hiking, climbing, running, swimming, field sports, waterfront recreation, boating, and archery. Further, in consideration from camp McCullough and first presbyterian church Tacoma agreeing to accept the afore mentioned child/individual as a camper/guest, I hereby personally assume all risks in connection with my child’s attendance and participation in the events at camp McCullough.
2. LIMITATIONS ON INSURANCE COVERAGE
I understand that my personal insurance coverage will be the primary coverage. No additional coverage is provided by Camp McCullough. I agree to the release of any records necessary for treatment, referral, billing or insurance purposes.
3. ACKNOWLEDGEMENT OF RESPONSIBILITY FOR DAMAGES
I agree that I am financially responsible for any damage to camp property caused by my child.
4. CONSENT TO ADDRESS DISCIPLINARY PROBLEMS
The afore mentioned camper agrees to obey all camp rules, and to fully cooperate with adult leadership, camp staff, and other campers. I agree that if in the judgment of the adult leadership or camp staff my child becomes a discipline problem, my child may be sent home, at my expense, and that I will forfeit all camp fees paid.
5. USE OF CHILD’S PHOTOGRAPH FOR PROMOTIONAL PURPOSES
I agree and consent that my child’s photograph may be used for promotional purposes or publicity material by Camp McCullough or First Presbyterian Church Tacoma.
6. ACKNOWLEDGEMENT OF COVID-19 RISK
I acknowledge the risk associated with my child attending Camp McCullough activities in person and agree to assume the risks to my child and my household. Camp McCullough will do its best to follow state mandated guidelines and sanitation protocols. No sanitation protocol can guarantee complete elimination of risk.
5. PRE-AUTHORIZE FOR MEDICAL TREATMENT
As previously listed, I authorize any medical and/or surgical treatment, including but not limited to hospital care, to be rendered to my child, as needed in the judgment of the treating physician, who is chosen by the Camp Program Manager, or a designated representative working under them, as circumstances require. I further authorize Camp McCullough Staff to render first-aid and to administer medication as prescribed and received at check in.
*I acknowledge that I am the parent/guardian of above named child. By my signature below (in the format: /s/John Smith), I acknowledge that I have read and understand the information set forth above, including the release and hold harmless agreement.
