Woody Acres Registration

Emergency Information

Please note: The camp staff will monitor but cannot administer medication.

Please list any medical conditions we should be made aware of (i.e. usage of an Epi-pen*, allergies, ADHD, ADD, physical disabilities, emotional problems, learning disabilities or anything special we should know about you or your child.

If you or your child has an allergy, please list the signs, symptoms, and treatment.

Due to our camp size, staffing, and accommodations, we cannot always accommodate all special requests and may recommend another week or a different camp.

Informed Consent and Acknowledgement

I hereby give my approval for my and the listed participants participation in any and all activities prepared by Camp Woody Acres during the selected camp. In exchange for the acceptance of said child’s candidacy by Camp Woody Acres ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Camp Woody Acres . and all its respective administration, staff, 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, I hereby waive all claims against Camp Woody Acres . including all staff and volnteers, 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 crafts. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

Permission is also granted to Camp Woody Acres staff and adminstration to provide the needed first aid treatment prior to the child’s transportation to the Janeway.

Note emergencies contacts will be made aware. 

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.

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.