Medical Release/ Consent Form
I am the legal guardian of the registered camper(s) who is under the age of 18 and wants to participate in French Broad River Camp (herein referred to as FBRC). In consideration of my child's participation in the program, I hereby release and discharge RiverLink, it's employees, agents, and volunteers (the 'Releases') from any and all liability, claims, claims for relief, damages, actions, causes of action and actionable wrongs of any kind, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, arising at law or in equity as a result of any and all actions and /or omissions of RiverLink, whether such liability or claim arises from an injury occurring at the camp location.
My child has permission to participate in all camp activities. In case of an emergency, I request and authorize any physician, hospital, and health care provider to provide medical treatment promptly, whether or not I may be contacted and informed.
I understand that the FBRC staff is not required to administer injections or medications or to perform medical procedures except in the case of life threatening emergency. I understand that FBRC staff will allow participants with parental permission to self-administer medication and/or injections where such medication and/or injection is physician ordered and directed. I further authorize FBRC staff to examine and render emergency or urgent medical care as they deem necessary.
RELEASE/CONSENT/PERMISSION STATEMENT
Submitted health history is completed as far as I know and if changes occur in health related conditions, I will contact FBRC. I understand that information provided will be shared on a 'need to know basis' with camp staff. I have reviewed the program and activities of the camp and the person described herein has permission to engage in all prescribed camp activities except as noted.
AUTHORIZATION FOR TREATMENT: I hereby give permission to the medical personnel selected by the camp to order x-rays, routine tests, treatment, and necessary transportation for my child. In the event that I cannot be reached in an emergency, I hereby give permission to the medical personnel selected by the camp to secure and administer treatment, including hospitalization, injection, anesthesia, or surgery for this child as named above.