Holy Spirit Filled
MEDICAL/COVID-19/INFECTIOUS DIEASE andMEDIA CONSENT:
MEDICAL:Incase of an emergency, I understand that every effort will be made to contact me(parent or guardian) oran immediate family member. In the event someone cannot be reached,I hereby give permission to the Camp Director, Camp Nurse, and physiciansselected by the camp, to secure proper treatment, and to administer"over-the-counter” (OTC), or prescription medications, to hospitalize, orderinjection, anesthesia, and/or surgery for myself. I understand that my insurance has theprimary responsibility for payment should I need treatment, and that the camp insurance is secondary. Iunderstand that, during the process of camp, all medications, including OTCmedications must be administered by camp personnel, and that medications willbe collected at time of registration. I certify that all the informationprovided on this application is accurate to the best of my knowledge. I have readand understand the camp rules and regulations, and also understand that bysigning this application I am agreeing to abide by those rules. I understandthat failure to do so could result in dismissal from camp. I also agree thatthe Church of God of Prophecy (local, regional, and international offices), andits officers, servants, or staff shall not be held responsible for damages forany accident or sickness involving myself.
COVID-19/INFECTIOUS DIEASE:Dueto the outbreak of Covid-19, Camp Big Cedars has put in place preventativemeasures to reduce the spread of Covid-19 and other contagious diseases;however, Camp Big Cedars cannot guarantee that you will not become infectedwith Covid-19 or any other infectious disease due to participation in campactivities.
Before comingtoCamp Big Cedars, please acknowledge that the following statements are true:
I will not attendcampif I or anymember of the household has exhibited any of the following symptoms within thelast 10 days:
Fever over 100.4 degrees / Extreme Fatigue / Dry cough /Difficulty breathing / New loss of taste or smell
I, as well asall household members havenotbeen diagnosed with Covid-19 in the last 14 days.
I, or anymember of the household has not traveled outside the country in the last 3weeks, prior to camp.
NOTE: If you have any questions regarding these conditions,please contact the camp director.
I acknowledge the contagious nature of Covid-19 and voluntarilyassume the risk that Imaybe exposed to. I understand that Camp Big Cedars, its staff and volunteers, theChurch of God of Prophecy (local, regional, and international offices) and itsofficers, volunteers or staff, cannot be held liable for any exposure toCovid-19 or any other infectious disease as a result of activities at Camp BigCedars or misinformation on this form provided by others.
MEDIA and PARTICIPATION:Ihereby give my permission for Camp Big Cedars administration to use images andrecordings of myself(includingwebsite or social media use) without further compensation. I agree that my I may participate in all campactivities including travel off the property. I also agree to hold harmlessCamp Big Cedars, its staff, and volunteers from any and all liabilities, claim,demands, and causes of action whatsoever, which may arise due to theparticipation of myself in said activities. If you have any questions/concerns,contact your camp directors via phone or email prior to camp. * Camp Big Cedarsis not responsible for lost items.
STATEMENT OF UNDERSTANDING AND CONSENT:Iunderstand that this camp is a ministry of the Church of God of Prophecy, andconsequently all actions, conduct, and policies will be consistent with theChurch’s Statement of Doctrine and Beliefs. I represent that I am the staff applicant named onthis application. I acknowledge and agree to the statements above, as well asany applicable terms and conditions for this registration.
I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.