Parent/Guardian Consent

I declare that I:

• have legal custody of the herein named child, or permission to register them to attend Camp Mishewah
• declare that the herein named child is in good physical and emotional health and amenable to Camp Mishewah authority
• will ensure that the herein named child will leave all electronic devices at home while at Camp Mishewah (Sr. Teen excluded)
• am responsible for payment of fees and any other expenses incurred by my herein named child

Medical Release

I declare that:
• the herein named child(ren) attending Camp Mishewah is/are covered by their provincial health plan or equivalent medical insurance
• to the best of my knowledge, my child(ren) is/are in good health. If my child(ren) becomes exposed to any serious/infectious diseases within four weeks of attending camp, I will notify the camp office
• that I have submitted my child(ren)’s up-to-date medical information and agree with the following Consent to Treatment statements:

• I give permission for the Camp Nurse or trained personnel to administer stock medications in case of minor injury, and/or illness during my child(ren)’s stay at Mishewah.
• I give permission for the Camp Nurse or trained personnel to provide Standard First Aid to my child(ren) as appropriate.
• I give permission for the Camp Health Nurse or trained personnel to administer medications provided by me as per indicated on the submitted health form.
• I give permission for Epinephrine to be administered to my child(ren) in case of an anaphylactic (life-threatening) reaction.
• I understand that every effort will be made to contact parents/guardians before any major treatment is administered.
• In case of a surgical emergency where I am not available for consultation, I hereby give permission to the physician selected by the Camp Director or designate to hospitalize, secure proper treatment for and to order injections, anesthesia, or surgery for my child(ren).
• I agree to indemnify and hold blameless Evergreen Christian Ministries, its staff, its directors and board, and the medical personnel representing the camp from and against any loss, damage, or injury suffered by the camper(s) as a result of being a participant in the normal activities of Camp Mishewah.
• I agree that all the information given on the Camper Health & Medical Form is correct and complete.
• I agree to pay all health related expenses and treatments not covered by the Provincial Health Plan (ie. lice treatments, medications, dressing supplies, casts, etc.)

Permissions
• I give permission for the herein named child(ren) to be transported by personal vehicle to offsite locations for hiking, canoeing, and excursions, or to be taken to the hospital/clinic for medical treatment if necessary.
• I give permission to Camp Mishewah to use photographs and video of the herein named child(ren) for promotional material. If you have questions or concerns, please contact the camp directors at [email protected]
• I give permission for the herein named child(ren) to participate at Camp Mishewah, its facilities, programs and activities. All physical programs and activities have risks and I understand there are physical risks and hazards inherent in any program or activity. I am allowing my child to participate and understand that I am exposing my child to inherent risks and hazards. I agree to accept all risks and hazards and be responsible for any injury or other loss which may occur during my child's participation. I understand that reasonable precautions shall be taken to ensure the health and safety of the herein named camper.
• By submitting this form, I acknowledge that I have read the Cancellation & Refund Policy and ECM Privacy Policy

Lice Checks
Lice Squad will perform lice checks at camper drop off before parents leave. If lice are found there are two options:

Option 1: If the camper chooses to go home, they will forfeit the week of camp. Refunds are NOT given for a camper who arrives at camp and returns home for treatment. Please be diligent and check at home.

Option 2: The Lice Squad will do the treatment at a cost of $95 + HST per hour, payable directly to the Lice Squad at the time of treatment. Normally, one hour will treat the camper.

You have selected Pay Their Way Camper Subsidy at the beginning of the form. No payment is required at this time. When done completing this form, please submit and you will be taken to the Sponsorship Application Form to complete. Thanks!