Parent or Guardian Release

A parent or legal guardian signature on this form is required to participate in the Prescott Day Camp program.

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For Emergency Treatment

I authorize Seaway Christian Church to arrange for transportation in case of an accident or acute illness of the participant. In the event it is not possible to receive instruction for the participant’s care, consent is given to any licensed physician for treatment. I allow the physician to administer medication and to perform necessary treatment for the preservation of the participant’s health and well-being. I understand that any cost incurred for treatment of sudden illness or accident shall be paid by me. This authorization and consent for treatment is given to Seaway Christian Church in conjunction with any authorized event.

 

General Release of Liability

In consideration for being allowed participant privileges in Day camp at Centennial Park, I hereby assume full responsibility for any risk of bodily injury, accidental death, or property damage while using the premises or any facilities or equipment herein. I further agree to hold harmless Seaway Christian Church, their employees, church council, and volunteers from any and all claims that may result from any action for damages, including but not limited, to such claims that may result from injury or death, accident or otherwise, during or arising in any way from said activity. I acknowledge that this General Release of Liability of Seaway Christian Church and its partners is binding on me and not my heirs.

 

Media Release

I hereby consent to the use of my/my child’s name, likeness and speech in any audio tape, video tape, film or photograph made in the Day Camp and Seaway Christian Church activity for the business or publicity purposes of the Day Camp and Seaway Christian Church. I understand that any participation offers no remuneration and that my/my child’s name, likeness and speech may be edited, produced, recorded for duplication and distribution throughout Canada and abroad.

 

I expressly release the Day Camp and Seaway Christian Church from any privacy, defamation, or other claims have arising out of broadcast, exhibition, publication, or promotion of this program.