Permission to Treat
This health history is correct to the best of my knowledge, and the person herein described has permission to engage in all prescribed camp activities, except as noted. I have read and completed in full the registration forms provided by the Carlisle Family YMCA and accept full responsibility for omissions or errors on the registration forms. I hereby give permission to the medical personnel selected by the camp director to provide routine health care; to administer medications; to order x-rays, routine tests and 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 permission to the physician selected by the camp director to secure and administer treatment, including hospitalization, for the registering camper. This completed form may be photocopied and used in the same manner for trips out of camp. Parents and guardians also will be notified when the child:
- Has an illness or an injury including but not limited to a head injury
- Has been involved in a physical fight, regardless of injury
- Has a temperature at or above 101 degrees
- Is being transported to the emergency room for any reason
- Has a suspicious mark or bite that has caused irritation or a mark
- Has suffered more than one bout of vomiting
- Has suffered from a fluid depleting illness for more than 8 hours (vomiting or diarrhea)
Hold Harmless Statement
I hereby assume responsibility for the risks associated with normal camp activity and release the Carlisle Family YMCA and its staff from any and all liability. I am aware and understand that participating in a Carlisle Family YMCA Camping program involves a potential risk of physical injury and I understand that normal camp activity can be physically demanding and potentially dangerous. I am aware and understand that all of the program activities are strictly voluntary, and it is my own choice to register my child after due consideration of his/her physical health; physical, mental and emotional abilities; and medical condition. In recognition of this, I, and/or my child, and/or my heirs and assigns, hereby release the Carlisle Family YMCA and its employees from all claims and liability from negligence or accidental injury arising from participation in the program. I further agree to hold harmless and indemnify the Carlisle Family YMCA and its agents for all defense costs, including attorney’s fees, and any other costs resulting in connection with my or my child’s participation in camp and all camp activities. I understand that this release includes all claims and liability during or after the program resulting from a preexisting medical condition. I also understand that this release includes all claims and liability resulting from unforeseen or intemperate weather. I have read this entire release of claims and fully understand it. I have satisfied any questions and concerns that I may have had regarding the Carlisle Family YMCA Camping programs by speaking with representatives of the camp. I am signing this form voluntarily and of my own free will and with full knowledge of all contents contained within.
Severe Weather Policy
All camps will spend most if not all of their day outside. In the case of severely hot days our staff will do their best to limit excessive play, take breaks in shade, give frequent water breaks to stay hydrated, re-apply sunscreen and go indoors when applicable (YADC). Please pack any additional precautions for your child: a towel that can get wet, additional water bottle, sunscreen, etc. If you choose not to send your child to camp on a hot day, no refunds will be given.
Each set of campers is given an orientation prior to riding in a camp vehicle. The orientation covers evacuation procedures, safety regulations and proper behavior. Passengers are instructed that they should remain seated at all times with hands and arms inside the vehicle. Seatbelts should be fastened – one person per seatbelt. Noise level should be such as to not distract the driver. There should be no throwing of objects or other disruptive behavior. Passengers should enter and leave the vehicle under the direction of a staff member and/or driver. If the vehicle makes an emergency stop, passengers should follow directions from staff members and/or driver and use the buddy system if leaving the vehicle. All new groups using a school bus or van will practice an emergency evacuation.
Pick Up / Drop Off
The camp is not responsible for the camper that has been signed out or has not yet been signed in and he/she is the responsibility of the parent or guardian until the camper has been signed in. We expect that parents and guardians will follow camp policies while on camp grounds. The person who drops the camper off each morning (or at the start of resident camp) is expected to be the same person who picks up the child, unless the staff is given written notice at the time of drop-off. This is to ensure the safety of your child. Also, if the camper will be picked up early, the staff should be notified at the time of drop-off. If alternate pick-up is being arranged, camp staff may ask to see a photo ID before releasing the camper. In the event of a planned change in pick-up or drop-off times of campers the Camp Director will communicate in writing to participants and / or guardians 24 hours prior to the change in schedule or pick-up / drop-off time. In the event of a delay in the transportation schedule of 20-30 minutes the Camp Director will notify the Welcome Center at the Carlisle Family YMCA and they will communicate the change to parents and / or guardians. In some instances parents / guardians will be notified directly by the Camp Director.
At the Carlisle Family YMCA, we view a successful camping season as a positive, joint venture between the parent/guardian, the camper and our staff. To make this possible, specific behaviors from both parents and children will not be tolerated in our programs. These behaviors include, but are not limited to: swearing, kicking, punching, biting, refusal to follow directions, refusal to stay within designated camp boundaries or threats directed towards other campers, campers’ families or our staff. If any of the behaviors listed above, or others negative in nature, are exhibited, the following actions will be taken:
- A verbal warning
- In camp discipline (ex. time-outs)
- Conference with parents or guardians
- Suspension or dismissal from the program
Note: We reserve the right to dismiss campers from the program without warning.
Photographs and videos will be taken of camping participants and staff and may be used for display, promotions or advertising unless otherwise specified during registration.
Brittany RoseCamping Services Director