I, hereby declare that I am the parent or legal guardian of the above participant, and consent that he/she may participate in activities at Hoodoo Adventure Company. I certify that the above information is true and accurate, and agree to advise Hoodoo Adventure Company, in writing, of any change to the medical condition of the person listed above. I understand that unless Hoodoo Adventure Company hears from me otherwise, they will assume all medical information is unchanged from the date of this agreement. June 18, 2021
Important Disclosure Information:
Information collected here is considered to be confidential and will be shared amongst healthcare providers (such as Emergency Health Care Providers, Walk-In Clinics, etc). This information will only be shared with Hoodoo Staff on a strict need-to-know basis to ensure the physical and mental well being of my child.
To the best of my knowledge, my child is in good health. I will notify Hoodoo Adventures in writing prior to arrival if there is any change in my child’s health, or if he or she is exposed to any communicable disease within 3 weeks prior to the camp. In the case of a medical emergency, I understand that every effort will be made to contact parents or guardians. In the event that I cannot be reached, I hereby give permission to Hoodoo Adventures to facilitate proper care for my child such as hospitalization, securing proper treatment, order injection, anesthesia, or surgery for my child as named above. I agree to reimburse Hoodoo Adventures for any prescriptions or medical expenses incurred for this camper.
I will submit any changes to this health form in writing to Hoodoo Adventures prior to arrival. June 18, 2021