Parent Camp Authorization Form

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The parental consent form for a child’s camp gives an organization or individual the freedom of liability during the time of the trip. The party that is traveling will need to be aware of any health conditions that minor has as well as all emergency contacts in the chance that something goes awry or if a medical procedure is needed. The form is usually required for organizations in an effort to hold themselves harmless from any accidents during a the child’s stay at under their care.

How to Write

Step 1 – Download in Adobe PDF (.pdf).

 

Step 2 – The information pertaining to the field trip participant (the child) must be submitted first. Enter the following in the first section of the form:

  • Full name
  • Gender
  • DOB
  • Age
  • Address
  • Phone number
  • Email
  • Guardian 1 name
  • Guardian 1 address
  • Guardian 1 cell phone
  • Guardian 1 home phone
  • Guardian 2 name
  • Guardian 2 cell phone
  • Guardian 2 work phone
  • Emergency contact name and relationship to child

Step 3 – A list of people who are permitted to pick up the child should be provided here. Start with the parent/guardian names then provide the name, phone number, age, and relationship to the participant of each authorized individual.

Step 4 – The parent or guardian should provide the name of the individual who they permit to administer CPR/First Aid to their child. The second field is for the name of the individual who should contact the parents in case of an emergency, and the third field is used to provide permission to the responsible adult to order emergency treatment should they deem it necessary.

Step 5 – Select whether photos will be taken at the event if not already checked off. Initial where applicable to give your consent.

Step 6 – Initial here to acknowledge that the participant’s personal items are his/her own responsibility.

Step 7 – Enter the emergency contact information of each applicable individual along with their relationship to the participant and their age. A guardian signature will be required once the form has been printed off.

Step 8 – Enter “Yes” or “No” to each statement listed in this section to inform those caring for the participant of any and all health conditions. If there is additional information that can be given relating to the child in question, provide that here.

Step 9 – If the participant has special needs, indicate if there is a special classification/diagnosis. If so, specify. A list of services, if any, that the child receives already from the Board of Education should be submitted here as well. Check “Yes” or “No” to indicate whether the child has behavioral issues.

Step 10 – Continuing the “Special Needs” section, provide any applicable information concerning the participant’s behavioral support needs. If paraprofessional support is needed, indicate this here. If you consent to the request for a copy of the participant’s IEP or any other evaluations from the Board of Educations, indicate that this is the case. Once the form has been printed out, each guardian must sign.