Camp I Can Pop-up: Thu, Oct 16, 2025

INFORMED CONSENT AND ACKNOWLEDGEMENT
I hereby give my approval for my child’s participation in any and all activities prepared by Camp I Can during the selected camp. In exchange for the acceptance of said child’s candidacy by Camp I Can, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Camp I Can and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Camp I Can. including all camp leaders and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all camp activities, including sports. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

MEDICAL RELEASE AND AUTHORIZATION
As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named camper. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Camp I Can and its affiliates including Directors, Camp Leaders, and camp Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered camp. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

CONFIRMATION
By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.

To ensure a safe and enjoyable environment for your child, we ask that they follow this code of conduct throughout the week of camp. We will explain these guidelines on the first day of camp, and as needed throughout, but would like you to be familiar with our policies to help prepare your child for a wonderful week of camp.

 

1. CODE OF CONDUCT
All campers are expected to:

1. Practice safe behaviors
2. Be kind to others and oneself
3. Keep hands to themselves, during non-physical activities
4. Be an active participant in all the activities each day

 

2. BULLYING POLICY
At Camp I Can for Girls, bullying is not tolerated in any form. Each camper is expected to treat all other campers with respect to help achieve the best possible experience for all. If a camper has difficulty meeting these expectations, parents/gaurdians may be called to assist.

We work together to ensure campers gain self-confidence, make new friends, and leave camp having had a positive experience. All incidents of bullying will be taken seriously and addressed by our leadership team.

 

3. BEHAVIOR GUIDELINES
Please read our behavior policy with your camper before camp.

We expect campers to always act in a safe manner when participating in our program and while at camp facilities – Holy Spirit School. Campers are to behave in a mature, responsible way and respect the rights and dignity of others.

Campers are expected to respect themselves and others while participating in all camp activities. Campers are not allowed to disrupt the Camp I Can program or leave activities without permission. Physical and verbal aggression is not allowed and will not be tolerated. Parents/guardians will be called if behavior becomes unsafe or unmanageable.

Campers should talk to a camp counselor, staff or volunteer if they are uncomfortable with any experiences or need assistance while at camp.

 

4. DISCIPLINE PROCEDURES
When a camper does not follow the behavior guidelines and/or code of conduct, the following action steps will be taken as behavior problems progress:

1. Staff will redirect the camper to more appropriate behavior.
2. If inappropriate behavior continues, the camper will be reminded of behavior guidelines and camp rules, and the camper will be asked to decide on action steps to correct her behavior.
3. If a camper’s behavior still does not meet expectations and is affecting the experience of other campers, a camp counselor will call the camper’s parent/guardian, and the parent/guardian will pick them up from camp for that day.
4. If inappropriate behavior continues, as a final action step, the camper may be dismissed from camp altogether.

Camper fees are non-refundable, including if a camper is sent home for disciplinary reasons. Physical violence or bullying toward another camper or staff member will result in immediate dismissal from the camp program. Behaviors that may result in immediate dismissal include, but are not limited to:

• Continued use of profanity, vulgarity or obscenity
• Stealing or damaging property (personal or camp property)
• Endangering the health and safety of children and/or staff
• Use of illicit drugs, alcohol or tobacco or sexual conduct of any kind
• Bullying of other campers or staff members
• Physical fighting of any kind
• Eloping from camp building

 

5. UNDERSTANDING OF PROGRAM
I understand that Camp I Can for Girls is an enrichment program to grow and develop social and emotional skills. It is NOT identification, treatment or remediation for any mental health problem. If you are concerned about your child’s mental health, please see an outside provider.

 

6. ACCIDENT/INJURY POLICY
I, the undersigned parent/guardian, understand that the employees and/or volunteer staff of Camp I Can for Girls will perform to the best of their abilities, and will endeavor to provide for the safety of all camp participants. I do however, agree to indemnify and otherwise hold harmless, Holy Spirit School and Phoenix School Counseling, if an accident or injury occurs to the above named child while participating in a camp activity. By signing this form, I acknowledge that I have read this paragraph and authorize the participation of this child in Camp I Can for Girls.

 

CONFIRMATION
I have read the above Policies and Procedures and confirm my understanding and acceptance. By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.

Photographs and video footage are an important marketing tool for Camp I Can for Girls and Phoenix School Counseling. Unless we have your permission, we will not take photos of your camper.

If permission is granted, the above camper’s name, likeness, image, voice, and/or appearance may be captured at Camp I Can for Girls and used in any marketing materials. I agree that the Phoenix School Counseling has complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the Phoenix School Counseling work and mission. These uses include, but are not limited to illustrations, bulletins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. I acknowledge that I will not receive any compensation for the use of such materials and hereby release Phoenix School Counseling and its agents and assignees from any and all claims which arise out of such use.