The health history is correct, insofar as I know, and the person described has permission to engage in all prescribed camp activities, except as noted by the examining physician and myself. The camp may require travel to an off-site activity or bus or vehicle and program components may or may not include: arts and crafts, swimming, field sports and other activities. Each participant who engages in any camp activity expressly assumes the risk of engaging in and the legal responsibility for injury, loss, or damage to person or property resulting from the risk of camp activities. I acknowledge and understand that participation in these activities involve the inherent risk of physical injury.
I, as a parent/guardian of a participant, understand my child/ward will be participating in activities that involve swimming and playing sports, etc. I understand that my child/ward will not be forced to do any activity and that despite all reasonable precautions taken, a guarantee of absolute safety is impossible. I and my child/ward agree to exercise good personal judgment and to ask for help if we are concerned about personal safety and to be responsible for deciding if a proposed activity is appropriate for myself/him/her. I and/or my child/ward agree to inform the instructors of any physical, mental or medical condition that might affect his/her ability to participate or affect other members of my group. I and/or my child/ward also realize that failure to provide/disclose that information could result in serious harm to him/her or others. I and/or my child/ward agree to comply with safety instructions given and to be responsible for his/her own personal safety and well-being.
I agree to hold Breathe California, Camp Superstuff, its directors, officers, employees, agents and/or associates harmless for any accidents, injury, loss of or damage to property that may occur during the camp, including any necessary transportation. I understand that all possible precautions are taken to insure that mature and qualified personnel conduct all programs and activities in a safe and responsible manner.
In the event of an emergency, I understand every attempt will be made to contact the parent/guardian. In the event that the parent/guardian cannot be reached, I give permission to Camp Superstuff to secure proper medical treatment. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child named on application. I understand that any medical expense not covered by Camp Superstuff’s medical insurance will be billed directly to me or to my insurance company.
I have read and understand this waiver and agree to abide by these terms and hereby release, indenify and hold harmless Camp Superstuff, Breathe California volunteers and/or contractors for transportation services from and against any and all claims, losses, suits, damages, or costs (including attorney fees) arising out of, resulting from or relating to my minor child/ward's participation in camp activities. I am aware this is a waiver and a release of liability and I sign it voluntarily.
Mandatory Parent Orientation: Thursday July 20th, 2017, 6:00 pm – 8:00 pm at Camp Superstuff site i.e. Mayfair Community Center, 2039 Kammerer Ave, San Jose, CA 95116 . Please only have one representative from your family attend the orientation.