Camp Echo of Pennsylvania

1. The undersigned hereby gives permission for the above-named minor(s) to participate in the Camp Echo program. Although reasonable precautions for the care and welfare of my child have been put into place, I recognize that injuries can occur even under the best of circumstances. I hereby release Camp Echo and the individual Camp Echo staff members and volunteers from all legal responsibilities for any injuries resulting from participating in the program.
2. The undersigned hereby grants permission to the medical staff at Camp Echo to:
   • Administer routine treatment and medication(s) for my child;
   • Render any emergency care required including medication(s); 
   • Transport my child to an emergency department/hospital for further treatment as needed.  
   • Access medical records and obtain other medical information as needed for purposes of administering treatment and caring for the camper(s).
3. I know and understand that I am financially responsible for the medical care and treatment rendered to the above-named camper if there is a charge for the medical services provided.
4. I will supply a list of approved medications that the above identified camper(s) are currently taking.  I will further provide any drug allergies or list other reactions the above camper may have. 
5. All campers will be given times for daytime rest, breaks and “cool downs.”  However, if there is a specific activity that you do not wish your child to participate in, please identify the activity below.
6. The undersigned grants permission for the above named camper / family to be interviewed/photographed/videotaped and/or used on the Camp Echo / Camp Victory website and Facebook page during the Camp Echo program week and for the use / publication of this material as a television, magazine, or newspaper story regarding the Camp Echo experience. I understand that such material will be kept on file by Camp Victory Board of Directors / Camp Echo and may be used again at some time for advertising or promotional use in the establishment, development and operations of Camp Victory.
7. Camp Echo will be compiling a camp directory with camper and staff addresses, e-mails and phone numbers so friendships can continue throughout the year.  I grant permission for this information to be provided and included in the directory.  This information will be shared with Camp Victory Board of Directors to be used for mailings as well.
8. In order to provide a supportive environment, I recognize that medical information about my child may be released as necessary to other camper(s) and/or medical and camp staff who are participating in Camp Echo. The undersigned grants permission for the release of such information.   
9. I understand that and give permission for the staff to inventory my son/daughter’s belongings, in the presence of two members of the staff and the camper, if the staff deems it necessary to do so for the health and safety of others at camp.

Any questions, please call Dawn Bressler at (570)784-1290 or (570)-594-1242 before 11 PM ET or email campechopa@gmail.com at any time.