Participant Authorizations:
I have read and understand the course/program information. I understand that I will be participating in physical activities (including, but not limited to those listed in the course/program descriptions) and the potential for accidents exists. I understand that the camp has established guidelines to minimize risks and provide a safe environment, and that Camp Bethel will implement multiple practices to limit the spread of and exposure to communicable diseases (including COVID-19 and other viruses), and that Camp Bethel is licensed by Virginia to operate a Summer Camp, Dining Hall and Swimming Pool, and that Camp Bethel adheres to over 300 operational and safety standards. In consideration of acceptance to Camp Bethel,
I indemnify and hold harmless Camp Bethel, the Virlina District Board–Church of the Brethren, Inc. and its staff, volunteers and officers from any and all liability, claims, damage, injury or illness sustained by me, and
I verify that the information on this Health Form is correct and complete as far as I know. This form may be copied for camp records, and
I hereby give permission to the camp to provide routine health care and seek emergency medical treatment. I agree to the release of any records necessary for emergency purposes. I give permission to the camp to arrange necessary emergency medical transportation for me. In the event I cannot communicate in an emergency, I hereby give permission to the physician selected by the camp to secure and administer treatment for me including ordering x-rays, administering tests, and admittance to a hospital, and
I understand that Camp Bethel provides only limited secondary medical insurance coverage for participants. I will possess proof of primary personal/family medical insurance coverage for me, and
I agree to read all information included in confirmation materials sent to me after registration and to share this information with my emergency contact person, and to read, sign and return any and all applicable forms and waivers, and
I permit photos, video and audio of activities or interviews that may include me to be used in camp/course promotion without liability or remuneration, and
I verify my Physical Assessment as described below. (We encourage participants to consult your family’s primary care physician to assess your current health and physical abilities. Provide any updates or changes to this information to leaders at check-in.)
I am physically able to participate in activities or instruction as described in the course information (unless specified in "additional information" above).