Summer Camp Application Form

I as the legal guardian of (camper name herein), give permission for my child to fully participate in the program of Bethany Birches Camp Inc. and all of the activities associated, for which my child is registered. I give permission for my child to be transported by approved camp staff and vehicles for camp activities and/or medical treatment. I give Bethany Birches Camp Inc. permission to use photographs, video and the like that include my child for publicity. I recognize that Bethany Birches Camp Inc. will not sell my address, phone number, e-mail address or personal information to anyone or organization. My permission is given with the understanding that Bethany Birches Camp Inc. staff will make reasonable efforts to ensure the safety and well-being of my child including adequate staff training, CPR training, general health and safety training, regular maintenance on equipment and maintaining reasonable camper/staff ratios. However, there are inherent risks associated with participating in any camp programs which, however slight the chances of occurrence, cannot be reasonably eliminated. These risks include but are not limited to falls, collisions, burns, getting lost, equipment failure or being struck by objects. There are general risks associated with behaviors of other participants, employees and agents of Bethany Birches Camp Inc.

In consideration of the permission granted the herein named child to participate in Bethany Birches Camp Inc. activities, I/we hereby release, and covenant with, Bethany Birches Camp Inc. that we will never, individually or as legal guardian(s) of said child, institute any action at law or in equity for any personal injuries, or injuries to property, real or personal, caused by, or arising out of camping and other related activities sponsored by Bethany Birches Camp Inc., its successors and legal representatives.