Sr. Youth Retreat

Please list any medical conditions, diagnoses, or health concerns we should be aware of. If none, write "none."

Name, Dosage, Timing etc

I give permission for a designated youth leader to administer my child's prescribed medications according to the instructions provided.

I give permission for a designated youth leader to administer over-the-counter medications or provide first aid as needed (e.g., bandages, antiseptic, paint relief).

I authorize Mountainside Camp Volunteers to seek medical attention for my child in the event of an emergency.

I understand that participation in youth activities involves some risk, and I release Mountainside Bible Camp from liability for injuries incurred while at Sr. Youth Retreat, except in cases of gross negligence.

I give permission for photos or videos of my child to be used for youth promotional purposes (website, social media, brochures).

Please type in either $50 or $100 depending on what amount best fits your family’s situation