Peacemakers' Day Camp

Full Name of Participant:

Email:

:

Option 1:

In the event of a medical emergency, when a parent or guardian cannot be reached immediately, I authorize the camp staff to approve medical treatment according to their best judgment. Parent or guardian's electronic signature (Initials):

Date:

:

Option 2:

In the event of a medical emergency, when a parent or guardian cannot be reached immediately, I direct you to contact the following for permission before any treatment is given:

Telephone Number(s):

Relationship to Child:

Parent or Guardian's Electronic Signature (Initials):

Date: