2018 Volunteer Health and Release Form

*Denotes Required Field

2018 Volunteer Health and Release Form

Each volunteer member must submit a fully completed form yearly.

Personal Information:

Position: Volunteer

Volunteer Week of Camp attending:

 ) -
 ) -
 ) -

Emergency Contact

 ) -

Medical Information

Please check all that apply to you:

Allergy Information:

  • Yes
  • No
  • Yes
  • No

Dietary Restrictions:

JOY's Food Services staff will make a reasonable effort to accommodate dietary sensitivities and existing dietary choices such as vegetarian and vegan diets. Full disclosure before your arrival at camp is required to accommodate the dietary needs of our volunteers.

PLEASE NOTE: Staff members with dietary restrictions may want to provide their favourite products. We carry a few gluten-free and dairy-free products, but they may not be the brands that you are used to. Do not bring almond or cashew milk, or other products containing nuts as we are a nut-free dining room and do not want to cause a threat to staff members, other volunteers or guests with severe nut allergies. JOY is only able to accommodate special diets due to medical reasons or existing lifestyle dietary choices, not for the purpose of weight loss or food dislikes. We encourage healthy living at camp and therefore overindulging/restricting of food intake, or significant changes in diet should not occur.

Medications

CONSENT / AUTHORIZATION: 

HEALTH COVERAGE 

  • The health history above is correct, and the volunteer named above has permission to engage in all prescribed camp activities except as noted.
  • I give permission to the nurse/caregiver selected by Joy Bible Camp to access and give medical advice to the named volunteer including medications that may relieve symptoms of minor illness and/or injury.
  • In the event that the named volunteer requires treatment beyond what is possible at Joy Bible Camp, I authorize the Executive Director of Joy Bible Camp and/or the nurse/caregiver in charge to transport and admit the named volunteer into appropriate care. (eg. Quinte Healthcare North Hastings).
  • Joy Bible Camp will make every attempt possible to contact the parent/guardian prior to any medical decision regarding an emergency with the above-mentioned volunteer. In the event that sufficient contact has not been made, I hereby give permission to the physician selected by the Executive Director and/or nurse/caregiver to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child named above. All expenses not covered by OHIP will be at the expense of the parent/guardian.

LIABILITY

  • Joy Bible Camp makes every effort to ensure that the experience of our volunteers has while in our care is a fun and safe experience. Every precaution is taken for a safe environment; some activities carry with them an inherent risk factor. By signing below, you understand and accept these risks and agree to allow your child to participate in such activities.
  • In addition, you release all directors, executive director, employees, and Officers of Joy Bible Camp including any third party facilities outside of the campgrounds from any and all claims for liability arising from your child’s participation in the activities at Joy Bible Camp. This release constitutes a waiver of legal rights and by signing below, you are also indicating that you have read carefully and fully understand the contents of this waiver.

Guardian's Digital Signature: (For those 17 years of age and younger)

Applicant's Digital Signature: