Parent’s Permission Form

Thank you for letting us know that your child/ren will be attending an upcoming camp.
Please fill out this form to give permission for your child to attend and to provide any other information (medical and contact) we need to know about your child while they are in our care during camp.

Child's Name

First Name

Last Name

MEDICAL INFORMATION

My child has the following allergies:

If there are no allergies, please tell us.

My child has the following medical conditions and requires the following medications:

If there is no medication needed, please tell us.

HEALTH AND SAFETY

I affirm that my child is physically fit to participate in the camp's activities. I understand that the camp involves physical and outdoor activities, and I assure that my child is adequately prepared and in good health to take part

YES

If no, please tell us what types of activities your child cannot do.

EMERGENCY CONTACTS

In case of an emergency, the following individuals should be contacted:

Emergency Contact 1

Please tell us Name, Relationship to Child and Contact Number

Emergency Contact 2

Please tell us Name, Relationship to Child and Contact Number

AUTHORISATION FOR MEDICATION TREATMENT

I give permission for Youth Leaders and/or First Aid Attendants to obtain any necessary medical treatment for my child in case of an emergency. I understand that every effort will be made to contact me; however, if I cannot be reached, I authorise the seeking of medical attention of my child. I will provide additional medical information regarding my child's health. Thank you for providing this opportunity for my child. I trust that all necessary safety measures will be in place during their time at the gathering.

PERMISSION GIVEN

Parent's Name