Loading...

GIRLS BUILD

  • First Aid Waiver

 


Please select the number of minors participating in Girls Build Camp.

First Aid Consent

Per the new law, Idaho Code 32-1015, consent is now required for routine first aid in Idaho. The statute states that any time an “individual” provides “a service” for the screening, examination, prevention, treatment, cure, care, or relief of any physical or mental health condition, illness, injury, defect, or disease, parental consent must first be received. This includes routine first aid, mental health check-ins, and any service that fits into the above categories.

If consent to treat is not given, your child will not be treated for any injury or illness unless your child has a life-threatening emergency event. Emergency services may be rendered by Girls Build staff/volunteers (examples: CPR/ AED, Epinephrine for anaphylaxis). 

I agree that if I do not consent to allow Girls Build staff, contractors and volunteers who are First Aid and CPR certified to provide medical attention to my child, I will be required to come to the camp location and administer first aid myself, or pick my child up to take home. Injured, overheated and ill children will not be allowed to remain at camp in an unhealthy condition. If consent is given, parents will be notified after basic first aid (band aids, burn cream, cooling techniques,etc.) are administered. Children will not be given any internal medications at camp. Parents will be notified when greater medical care seems necessary

I thereby CONSENT to the treatment of my minor child by Girls Build staff, contractor or medical volunteer for same day illness or injury to our minor child while at Girls Build Summer Camp.

Yes, I consent to my child being treated for injuries and illness
No, I do not consent to my child being treated for injuries and illness (you will be contacted and need to pick up your child, or come administer first aid)
First Participant's Name
First Name*
Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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*
Last Name*
Relationship*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!