Camp Registration Authorization

The health history provided for my camper's registration is correct so far as I know, and the person therein described has permission to engage in all camp activities except as noted in writing.

 

Authorization for treatment: I hereby give permission to the medical personnel selected by the camp director of Southern California Bible Conference, 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 permission to the physician selected by the Camp Director to secure and administer treatment, including hospitalization for the person named above. The submitted registration form may be printed for trips out of camp. I also understand my child’s photo may be taken at camp. I authorize verdugo pines bible camp to use these photos for camper enjoyment or promotional purposes. This authorization shall remain effective unless revoked in writing.