Name of Participant *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Participant Phone

Optional

(###)

###

####

Parent/Guardian Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone *

(###)

###

####

Name of Parent/Guardian completing this form. *

First Name

Last Name

Name of Youth Participant. *

First Name

Last Name

Permission, Waiver, and Release: I am the parent or guardian of this youth, and give my permission for this youth to participate in CARE FOR CREATION CAMP sponsored by Trinity Episcopal Cathedral. Given my desire for this youth to so participate, I hereby release, agree not sue, and agree to hold harmless Trinity Episcopal Cathedral (including its officers, directors, employees, representatives, agents and affiliates) and the volunteers of CARE FOR CREATION CAMP from all claims, demands, liability and actions of any kind including acts of negligence, arising out of the participation of the identified youth and resulting in the youth’s personal injury and also claims for loss of or damage to the youth’s property unless the injury, loss, or damage is caused by willful misconduct. *

I consent

COVID Safety: As the parent or guardian of this youth, I understand that adherence to safety precautions to prevent the spread of COVID-19 at CARE FOR CREATION CAMP must be followed by this youth and all camp participants. Safety precautions include, but are not limited to, wearing a face mask at all times while indoors (with the exception of while eating), and following any additional guidelines set by the organizations at which we are visiting during camp. If this youth is unable to follow these safety precautions, or other camp rules and regulations, I understand that I will be notified by the camp director and am responsible for arranging transportation for this youth to leave CARE FOR CREATION CAMP. *

I consent

Driver Consent: As the parent or guardian of this youth, I understand that CARE FOR CREATION CAMP involves traveling to locations other than Trinity Episcopal Cathedral, and I give Trinity Episcopal Cathedral (including its officers, directors, employees, representatives, agents, affiliates and volunteers) permission to transport this youth during the event for the express purpose of traveling to and from CARE FOR CREATION CAMP activity locations. I understand that if I do not consent to this release, that I am responsible for arranging the transportation of this youth during CARE FOR CREATION CAMP.

I consent

Medical Consent: As the parent or guardian of this youth participating in CARE FOR CREATION CAMP sponsored by Trinity Episcopal Cathedral, I authorize any adult associated with the event to consent to any medical examination, diagnosis, treatment, and/or hospital care that is reasonably necessary to care for this child. I agree to remain financially responsible to pay all costs and expenses incurred in connection with needed medical service rendered to this youth.

I consent

Media Release: As the parent or guardian of this youth, I give any adult associated with this event permission to record the participation of this youth in CARE FOR CREATION CAMP by photo, video, electronic or audio means. Additionally, Trinity Episcopal Cathedral may use these recordings in any future presentation (print, video, website, or social media) without payments of fees, royalties, special credits, or other compensation

I consent