SayPro Consent and Waiver Form Template: A document for participants to sign, acknowledging camp terms and potential risks.

Sure! Here’s a detailed SayPro Consent and Waiver Form Template, tailored for camp participants. This form ensures that participants (or their legal guardians) fully understand the nature of the camp, its terms, and any associated risks.

SayPro Consent and Waiver Form Template

Camp Name: ______________________________________
Date(s) of Camp: _________________________________
Location: _________________________________________

Participant Information

– Full Name: ____________________________________________
– Date of Birth: __________________________________________
– Gender: ______________________________________________
– Address: _____________________________________________
– City/State/Zip: ________________________________________
– Phone Number: _______________________________________
– Email Address: ________________________________________

Emergency Contact Information

– Name: ______________________________________________
– Relationship to Participant: ____________________________
– Phone Number: ______________________________________
– Alternate Phone Number: _____________________________

Medical Information

– Allergies (food, medication, etc.): _______________________
– Medical Conditions: ___________________________________
– Medications (taken regularly): ___________________________
– Health Insurance Provider: ____________________________
– Policy Number: _______________________________________

Consent and Acknowledgement of Risk

I, the undersigned participant (or legal guardian of the participant), hereby acknowledge and agree to the following:

1. Voluntary Participation: I am voluntarily participating (or allowing my child/ward to participate) in the SayPro Camp. I understand that participation is not without risk.

2. Inherent Risks: I understand that participation in camp activities may involve physical exertion, outdoor exposure, recreational sports, and other inherent risks that may result in injury, illness, or in rare cases, serious harm.

3. Medical Care: I authorize SayPro staff to administer basic first aid and to secure emergency medical care for the participant if necessary. I understand that I am financially responsible for any medical treatment provided.

4. Medical Fitness: To the best of my knowledge, the participant is in good physical health and is capable of participating in the camp activities.

5. Release of Liability: I hereby release and hold harmless SayPro, its staff, volunteers, affiliates, and representatives from any and all liability, claims, demands, and causes of action related to loss, damage, or injury that may be sustained while participating in the camp.

6. Photo/Video Release: I give permission for SayPro to photograph or record the participant during camp activities and to use such media for promotional, educational, or informational purposes, without compensation.

7. Code of Conduct: I acknowledge that participants are expected to behave respectfully and abide by camp rules. Disruptive or unsafe behavior may result in removal from the camp without refund.

8. Transportation (if applicable): I give permission for SayPro to transport the participant to and from camp activities and locations, where necessary.

Consent and Signature

I have read, understood, and agree to the terms outlined in this Consent and Waiver Form.

Participant’s Signature: ____________________________ Date: _______________
(If over 18 years of age)

Parent/Guardian Name: ____________________________
Signature of Parent/Guardian: ______________________ Date: _______________
(Required if participant is under 18)

SayPro Camp Staff Use Only

– Received By: __________________________________________
– Date Received: ________________________________________

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