Camp Iliff

Upon submission of this form, the parent or guardian is granting permission for the child to be transported by Iliff's Camps & Clinics, LLC, personal vehicles, or by its contracted providers to and from school, day trips or extra-curricular activities. The health information indicated here is correct to the best of your knowledge. The child has permission to engage in all prescribed activities except if noted otherwise. In the event of an emergency, if a parent or guardian cannot be reached, permission is being granted to the physician selected be the Camp Director to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for this child. Further authorization is given to the Camp Director or his designee to provide over the counter medication to this child as necessary. The parent or guardian also agrees that in case of an injury to his or her child that is due to natural causes or by accident which involved no neglect by any camp staff that Iliff's Camps and Clinics, LLC or the staff will not be held liable. Camp Iliff reserves the right to change a trip location with out prior notice. Iliff's Camps and Clinics, LLC, has permission to transport my child to and from camp activities as necessary.

*You will be required to sign this statement when you come to our facility. You will also be required to fill out a Health History form for each child and provide a copy of each child's immunization records.