Camper Permission Form

Please fill out your student's information and read then sign the release below.

Parental Permission and Release from Liability

I, the parent/guardian of the above-named youth, do hereby give my approval to participate in the supervised activities of Urban Outreach, Inc.  I assume all risks and hazards incidental to the conduct of the activities, and I do hereby release, absolve, indemnify, and hold harmless Urban Outreach, Inc., their employees, volunteers, organizers, sponsors, and supervisors of the activities, any and all of them.  In case of injury to my child, I hereby waive all claims against the organizers, the sponsors, and any of the supervisors and volunteers appointed by them.  I likewise release from responsibility any person transporting my child to or from the activities.

In addition, I agree and consent to have staff members, counselors, or volunteers of Urban Outreach, Inc. secure any emergency care or treatment necessary for mychild while he/she is in their care if I cannot be contacted at any of the telephone numbers listed above. I further assume all responsibility for the decision so made.  I agree to participate in this project and hereby grant permission to photograph or interview my child, and I understand that portions may be used for public view.  i understand and agree this releases Urban Outreach, Inc. from any remuneration, and from any future claims as well as any liability arising from the use of said photograph or interview. Also, I understand that my child must be the proper age.  I understand that if my child is not the required age, the child may be sent back home or the parent/guardian must come for the child to return them from this event.

When you click the "Submit" button, you will begin the Camper Registration Form.  For your camper's safety, we require a lot of information. Please fill out all 7 pages to complete your camper's registration.