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Waiver

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Camper Info

Child's Name*
MM slash DD slash YYYY
Camps(s)
Please check the camp(s) that your child is participating in.

Camper Health Info

Waiver Info

Participation Agreement*
I/We acknowledge that my child is enrolled in the MWV School to Career Summer Camp, 2023. My child is in good health and able to participate in the Camp’s activities. Camp organizers will do everything possible to assure that the campers will have a fun, safe and productive experience at the camp. We do need you to understand that the participating agencies and staff of this camp are not responsible for accidents and medical or dental expenses incurred as a result of participation in this program. Accordingly, we ask that parents(s)/guardian(s) complete and sign this waiver.
Release*
I/We wish that our child participates in the MWV School to Career Summer Day Camp, which is organized and administered by the Mt. Washington Valley School to Career Partnership. I am familiar with and recognize the risks inherent in the program and I assume all the risks of injury and loss arising or resulting from my child’s participation, hereby releasing and holding harmless all agencies, its employees or agents, from liability for any such injury or loss.
Medical Consent*
The medical consent form permits hospital personnel to begin emergency treatment immediately rather than encounter a delay while the adult’s permission is sought.

I/we authorize the MWV School to Career Summer Camp staff to carry out standard first aid, including treatment for severe allergic reaction to insect stings, and to arrange for emergency care for my/our minor child at a local hospital, as the staff deems necessary. I authorize hospital personnel to provide emergency medical treatment for my/our child.
Travel Permission*
I/We give permission for our child to travel to various sites in the MWV Region by school bus, under supervision of the MWV School to Career Summer Camp staff.
Photo Release*
I/We understand that our child/ward may be photographed and/or videoed during participation in the MWV School to Career Summer Camp. The video and photographs will be used for press releases and presentations by program staff. I give my permission for my child to be videoed and/or photographed for promotional and educational purposes only.

Parent/Guardian Info

Please feel free to comment on any other information you think would be helpful for us to ensure that your child enjoys the week at camp.
Would you like an email notification with completed waiver in PDF format?
Waiver Copy Email*
Parent/Guardian 1*
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MM slash DD slash YYYY
Parent/Guardian 2
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MM slash DD slash YYYY

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PO Box 985 | Conway, NH 03818

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