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TOVO Residential Camp Program 2024 Permission Slip

Welcome to TOVO. We are delighted your child will be participating in a wonderful experience with us. Please fill out and sign the following information.

 

Terms and Conditions

I, the parent or guardian of the below child, give permission for my child to receive emergency medical or surgical treatment and hospitalization if necessary. I understand that every attempt will be made to contact me, or the person named below, before taking any medical action. I hereby waive and release the TOVO Management from any liability for any injury or illness incurred while at camp. I UNDERSTAND THAT THERE IS A RISK TO MY CHILD AS A RESULT OF CAMP ACTIVITIES, AND KNOWINGLY AND VOLUNTARILY ASSUME ALL RISK OF SUCH INJURY. I will be financially responsible for any medical attention needed during camp or resulting from an injury received at camp.

I hereby certify the named athlete is physically able to participate in the Soccer Camp and that I know of no restrictions, physical impairments, or any other facts, which in any manner limit his/her participation in such a program.

I understand TOVO retains the right to use for publicity purposes, photographs of campers taken at camp.

 

TOVO Residential Camp Program 2024 Medical & Health Insurance Information Form

I hereby certify the named camper is physically able to participate in the TOVO Soccer Camp and that I know of no restrictions, physical impairments, or any other facts, which in any manner limit his/her participation in such a program.

 

INSURANCE INFORMATION

I, the parent of , give permission for my child to receive emergency medical or surgical treatment and hospitalization if necessary. I understand that every attempt will be made to contact me, or the named person below, before taking this action. I hereby waive and release the Camp Management from any liability for any injury or illness incurred while at camp. I UNDERSTAND THAT THERE IS A RISK OF INJURY TO MY CHILD AS A RESULT OF CAMP ACTIVITIES, AND KNOWINGLY AND VOLUNTARILY ASSUME ALL RISK OF SUCH INJURY. I will be financially responsible for any medical attention needed during camp or resulting from an injury received at camp.

 

TOVO Residential Camp Program 2024 COVID19 Waiver

A parent or guardian must complete the below screening prior to check in at camp.

I am aware of the risk of illness, including viral and bacterial illnesses, while my child is at the program. I am aware that my child will interact in close proximity to and with other children and adults for extended periods of time while at the program. Although the program maintains proper (and enhanced) hygiene and infection control practices, it is impossible to guarantee that your child (or anyone else at the program) will not become sick or be exposed to illness, including COVID-19. By signing this document, you acknowledge your understanding that during the program your child will spend a significant amount of time around many children and adults, and that it is possible that your child may become sick with or exposed to any illness, including COVID-19, whether at camp or elsewhere.

Today's Date: December 28, 2024 

 

 

 

 

 

Please select who will be participating...
AdultMinor
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First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Weight

Height

HEALTH HISTORY 


If the camper should be restricted from any activities please note

If the camper will be taking medication during camp, please indicate name of drug and dosage

Please identify any medical condition or history, which would require special attention
Has the camper had? (Please check boxes for YES)
German Measles
Measles, Mumps
Asthma
Chicken Pox
Pneumonia
Diabetes
High Blood Pressure

Medication 

I agree to allow camp to administer Tylenol and/or Ibuprofen*
No
Yes

Allergies

Any food allergies?*
No
Yes

(Specific situations must be discussed with the TOVO Director prior to registration. All dietary restriction and/or needs must be noted.) 


Food allergies
Allergies
Asthma
Eczema
Insect Stings
Other

If other, please explain

Drug Reactions
Drug Reactions
Penicillin
Antibiotics

Antibiotics(type)
I acknowledge that my camper has had a physical in the last year and is in good health. *
Yes



TOVO Residential Camp Program 2024  COVID19 Waiver 





1. Does the player have a temperature of 100.4 or higher?*
No
Yes
2. Has the player had close contact with a person with confirmed COVID-19 in the last 14 days?*
No
Yes
3. Has the player shown signs of fever or chills within the last 24 hours?*
No
Yes
4. Has the player had diarrhea, vomiting, or abdominal pain within the last 24 hours?*
No
Yes
5. Has the player had an uncontrolled cough that causes difficulty breathing within the last 24 hours?*
No
Yes
6. Has the player had a severe headache or sore throat within the last 24 hours?*
No
Yes
7. Has the player reported not being able to taste or smell within the last 10 days?*
No
Yes
8. Has this player had both doses of the Covid 19 vaccine?*
No
Yes
First Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
INSURANCE INFORMATION

Carrier Name *

Carrier address *

City *

State *

Zip *

Policy Number *

Exp *

Policy Holder Name *

Policy Holder Date of Birth *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Weight

Height

HEALTH HISTORY 


If the camper should be restricted from any activities please note

If the camper will be taking medication during camp, please indicate name of drug and dosage

Please identify any medical condition or history, which would require special attention
Has the camper had? (Please check boxes for YES)
German Measles
Measles, Mumps
Asthma
Chicken Pox
Pneumonia
Diabetes
High Blood Pressure

Medication 

I agree to allow camp to administer Tylenol and/or Ibuprofen*
No
Yes

Allergies

Any food allergies?*
No
Yes

(Specific situations must be discussed with the TOVO Director prior to registration. All dietary restriction and/or needs must be noted.) 


Food allergies
Allergies
Asthma
Eczema
Insect Stings
Other

If other, please explain

Drug Reactions
Drug Reactions
Penicillin
Antibiotics

Antibiotics(type)
I acknowledge that my camper has had a physical in the last year and is in good health. *
Yes



TOVO Residential Camp Program 2024  COVID19 Waiver 





1. Does the player have a temperature of 100.4 or higher?*
No
Yes
2. Has the player had close contact with a person with confirmed COVID-19 in the last 14 days?*
No
Yes
3. Has the player shown signs of fever or chills within the last 24 hours?*
No
Yes
4. Has the player had diarrhea, vomiting, or abdominal pain within the last 24 hours?*
No
Yes
5. Has the player had an uncontrolled cough that causes difficulty breathing within the last 24 hours?*
No
Yes
6. Has the player had a severe headache or sore throat within the last 24 hours?*
No
Yes
7. Has the player reported not being able to taste or smell within the last 10 days?*
No
Yes
8. Has this player had both doses of the Covid 19 vaccine?*
No
Yes
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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