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:
  • Yes
  • No
  • Yes
  • No

Medications

CONSENT / AUTHORIZATION: 

HEALTH COVERAGE 

The health history above is correct, and the staff member/volunteer named above has the 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 my son/daughter including medications that may relieve symptoms from minor illness and/or injury. In the event that my son/daughter requires treatment beyond what is possible at Joy Bible Camp, we authorize the Executive Director of Joy Bible Camp and/or the nurse/caregiver in charge to transport and admit our son/daughter 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 camper. In the event that sufficient contact has not been made, I hereby give permission to the physician selected by the Administrator 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 that your son/daughter 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. The staff members are occasionally driven to town by a responsible adult; weekly, we will rent a bus to take the whole staff to town. 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, administrator, employees, and Officers of Joy Bible Camp including any third party facilities outside of the camp grounds 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: