If you registered online, you need to sign the Medical & Photo Release below and mail or bring this to camp along with any payment due:
Camp Session_______________________________________________________
1st Camper’s Name _________________________________________, has permission to engage in all prescribed camp activities except as noted. I hereby give permission to the medical personnel selected by the camp administrators to order X-rays, routine tests, treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation for me/or my child. In the event I cannot be reached in an emergency, I hereby give my permission to the physician selected by the camp administrators to secure and administer treatment, including hospitalization, for the person named above. This form may be photocopied for trips out of camp. I will allow my child’s picture to be taken for use in the promotion and publicity efforts of Camp CILCA Outdoor Ministries.
Signature of parent/legal guardian (or self if over 18):_______________________________________________ Date________ Camp CILCA - 4124 Camp CILCA Road - Cantrall, IL 62625
If you registered online, you need to sign the Medical & Photo Release below and mail or bring this to camp along with any payment due:
Camp Session_______________________________________________________
2nd Camper’s Name _________________________________________, has permission to engage in all prescribed camp activities except as noted. I hereby give permission to the medical personnel selected by the camp administrators to order X-rays, routine tests, treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation for me/or my child. In the event I cannot be reached in an emergency, I hereby give my permission to the physician selected by the camp administrators to secure and administer treatment, including hospitalization, for the person named above. This form may be photocopied for trips out of camp. I will allow my child’s picture to be taken for use in the promotion and publicity efforts of Camp CILCA Outdoor Ministries.
Signature of parent/legal guardian (or self if over 18):_______________________________________________ Date________ Camp CILCA - 4124 Camp CILCA Road - Cantrall, IL 62625
If you registered online, you need to sign the Medical & Photo Release below and mail or bring this to camp along with any payment due:
Camp Session_______________________________________________________
3rd Camper’s Name _________________________________________, has permission to engage in all prescribed camp activities except as noted. I hereby give permission to the medical personnel selected by the camp administrators to order X-rays, routine tests, treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation for me/or my child. In the event I cannot be reached in an emergency, I hereby give my permission to the physician selected by the camp administrators to secure and administer treatment, including hospitalization, for the person named above. This form may be photocopied for trips out of camp. I will allow my child’s picture to be taken for use in the promotion and publicity efforts of Camp CILCA Outdoor Ministries.
Signature of parent/legal guardian (or self if over 18):_______________________________________________ Date________ Camp CILCA - 4124 Camp CILCA Road - Cantrall, IL 62625