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Medical Emergency and Liability Waiver
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In the event I cannot be reached in an EMERGENCY, I hereby give permission to the physician or Hospital Selected by the Camp Staff to hospitalize, secure proper treatment for , and to order injection, anesthesia, or surgery for my child named in this registration from. My child may participate in activities off the camp grounds, such as hiking, swimming and boating nearby. I am aware of and understand the risks and hazards of young people's activities in which my child may take part while a camper, including but not limited to paintball (if checked yes on registration) recreational and sporting activities, and transportation to such activities. I hereby acknowledge and voluntarily assume all risk of loss, damage or injury, whether to person or property, that may be sustained by my child while a participant in the Camp, whether on or off the camp premises, and hereby release all volunteers and employees from any and all liabilities, claims, demands, and actions arising out of or related to the participation of my child in the Summer Camps. This release shall be binding upon the heirs, administrators, executors and assigns of myself and my child. Your signature signifies that you have read the brochure, understand and agree to the foregoing, and wish your child to attend the Winter Snow Camp at Shiloh Chapel this year. Signature of Parent:_______________________________ Date:_________
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Contact the Pastor: Pastor@shilohchapelmaine.org Send mail to: Donwa1@shilohchapelmaine.org with questions or comments about this web site.
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