Please initial each box acknowledging your informed release.
I have reviewed and thoroughly completed the Health History Form for my child. As such, I hereby give permission to the WeHaKee Camp for Girls medical personnel to provide medical care in accordance with recommended camp treatment procedures, administer prescription and non-prescription medication, and order routine tests, X-rays and transportation as needed for my child. I attest that all of my child’s immunizations are up to date in accordance with the American Academy of Pediatrics’ most recent Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger. I give permission to the physician selected by the camp to order x-rays, routine tests, and treatment related to the health of my child for both routine health care and in emergency situations. If I cannot be reached in an emergency, I give my permission to the physician to hospitalize, secure proper treatment for and order injection, anesthesia, or surgery for this child. In the event that my child is hospitalized for an extended period (more than 1 night), I understand that I am responsible for making immediate arrangements to travel to their hospital location to provide supervision, personal support, transportation, etc. In addition, WeHaKee Camp for Girls has my permission to obtain a copy of my child’s health record from providers who treat my child and these providers may talk with the program’s staff about my child’s health status.
I, agree to be a positive and respectful member of the WeHaKee community throughout my session at WeHaKee Camp for Girls. In addition, I have discussed the WeHaKee Camp Guide with my parent/guardian and understand and accept what is expected of me as a member of the WeHaKee Camp for Girls community. I specifically understand what behaviors are acceptable and unacceptable at WeHaKee Camp for Girls as discussed in the Expectations at Camp section of the guide. Additionally, I agree not to post photos, video, logos or other images of WeHaKee Camp for Girls or its participants on internet sites or other broadcast electronic means of any kind.