Permission & Medical Release
Date of Camp: June 14-16, 2018
I give permission for my child to participate in all Girls’ Camp activities including swimming, canoeing, hiking, camp duties, sports, obstacle course, and crafts.
I give the Director and/or Staff of the Sparks Nevada Stake Girl’s Camp authority to administer treatment to my child for any accident or illness and act in my stead in approving necessary medical care. Further I authorize any medical provider and/or medical facility to release information of any kind regarding my child to the camp directors: Melissa Case, camp nurses, and Stake YW Presidency, Julie Marchant, Kathy Solaegui, Robin Sommers, and Sandy Ferrante. This authorization is inclusive of the dates of the camp. This authorization shall expire upon return home from this activity or when medical treatment is no longer required, whichever is later. This authorization may be revoked earlier, orally or in writing per HIPAA regulations.