• Ohio DECA Summer Leadership Retreat

    FFA Camp Muskingum, Carrollton, Ohio. July 10-13, 2026
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Emergency Medical Authorization Form

  • Format: (000) 000-0000.
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  • Residential Parent or Guardian

  • Purpose: to enable parents and guardians to authorize the provision of emergency treatment for students who become ill or injured while under school authority, when parents or guardian cannot be reached.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • PART 1 OR 2 MUST BE COMPLETED

  • PART 1 - To grant consent

    I hereby give consent for the following medical care providers and local hospital to be called:
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • In the event reasonable attempts to contact me have been unsuccessful, I hereby give my consent for (1) The administration of any treatment deemed necessary by above-named doctor, or, in the event the designated preferred practitioner is not available, by another licensed physician or dentist; and (2) the transfer of the child to any hospital reasonably accessible. This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentist, concurring in the necessity for such surgery, are obtained prior to the performance of such surgery.

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  • PART 2 - Refusal to consent

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  • Ohio DECA Summer Leadership Retreat Attendance and Emergency/Medical Release Form

  • ATTENDANCE

  • This is to certify that   *   *   has permission to attend the above named DECA activity. I also do hereby on behalf of him/her absolve and release the Ohio DECA and Ohio DECA SLR staff from any claims for personal injuries or illness which might be sustained while he/she is en route to and from or during the DECA sponsored activity. 

  • EMERGENCY

  • I authorize the advisor or retreat director to secure the services of a physician or hospital, and to incur the expenses for necessary services in the event of accident or illness, and I will provide for the payment of these costs. We have read and agree to abide by the terms listed above. We also agree that Ohio DECA has the right to send the above mention student home from the activity at our expense, provided that he/she has violated the conference rules and/or his/her conduct has become a detriment

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  • Format: (000) 000-0000.
  • Ohio FFA Camp, Inc., in conjunction with Ohio DECA Minor Participant Waiver, Release, Indemnification of All Claims & Covenant Not to Sue Form NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document carefully and in its entirety. By signing this agreement, you give up your right to bring a court action to recover compensation or obtain any other remedy for any personal injury or property damage however caused arising out of your participation in Ohio FFA Camps, Inc. & Ohio DECA Programs, now or at any time in the future. Acknowledgement of Risk I, in my legal capacity as the parent/guardian of the minor named below, do hereby acknowledge and agree participation in Ohio FFA Camps, Inc. & Ohio DECA programs/activities comes with inherent risks. I have full knowledge and understanding of the inherent risks associated with Ohio FFA Camps, Inc. & Ohio DECA program participation, including but in no way limited to: (1) slips, trips, and falls, (2) aquatic injuries, (3) athletic injuries, and (4) illness, including exposure to and infection with viruses or bacteria. I further acknowledge that the preceding list is not inclusive of all possible risks associated with Ohio FFA Camps, Inc. program participation and that said list in no way limits the operation of this Agreement. Coronavirus/COVID-19 Warning and Disclaimer Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to person contact. Federal and state authorities recommend social distancing to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in Ohio FFA Camps, Inc. & Ohio DECA programs or accessing Ohio FFA Camps, Inc. facilities could increase the risk of contracting COVID-19. Ohio FFA Camps, Inc. & Ohio DECA in no way assures COVID-19 infection will not occur through participation in Ohio FFA Camps, Inc. & Ohio DECA programs or accessing Ohio FFA Camps, Inc. facilities.

  • In consideration of   *   *   ’s participation in Ohio FFA Camps, Inc. & Ohio DECA programs and use of Ohio FFA Camps, Inc. facilities, I, the undersigned parent/guardian of the named minor, agree to release and on behalf of myself and the minor named above, my heirs, representatives, executors, administrators, and assign, HEREBY DO RELEASE Ohio FFA Camps, Inc., & Ohio DECA its officers, directors, employees, volunteers, agents, representatives and insurers (“Releasees”) from any causes of action, claims, or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I, the named minor, my heirs, representatives, executors, administrators, and assigns may have, now or in the future, against Ohio FFA Camps, Inc. & Ohio DECA on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to the use of Ohio FFA Camps, Inc. facilities/equipment or participation in Ohio FFA Camps, Inc. & Ohio DECA programs whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of the Releasees. I hereby certify on behalf of myself and the named minor that I have full knowledge of the nature and extent of the risks inherent in Ohio FFA Camps, Inc. & Ohio DECA program participation and that I, on behalf of myself and the named minor, am voluntarily assuming said risks. I understand that I and the named minor will be solely responsible for any loss or damage, including personal injury, property damage, or death, the named minor sustains while participating in Ohio FFA Camps, Inc. & Ohio DECA programs and that by signing this agreement I, on behalf of myself and the named minor, HEREBY RELEASE Releasees from all liability for such loss, damage, or death. I further certify that the named minor is in good health and has no conditions or impairments, which would preclude his/her safe participation in Ohio FFA Camps, Inc. & Ohio DECA programs. I further certify I have legal capacity to act as the parent/guardian of the named minor. I further understand that the terms of this agreement are legally binding and certify that I am signing this agreement, after having carefully read it, of my own free will.  

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  • Over-the-Counter Medical Form

    Facts concerning the student’s medical history including allergies, medications currentlybeing taken, and any physical impairments to which a physician should be alerted:
  • I give permission for my child to receive an adult dose as prescribed on the medication label, as needed, for:

    These OTC medications will be provided so it is not necessary for students to bring these with them on the trip.
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  • Payments are processed through PayPal.  You may pay using an existing PayPal account, or any major credit card / debit card.

     
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      OHIO DECA SUMMER LEADERSHIP RETREAT REGISTRATION
      $250.00
        
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      $0.00
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