CAMP O-KI-HI TRANSPORTATION PERMISSION
I hereby give my permission for my child ______to be transported by private vehicle by any registered adult staff member while attending Camp O-Ki-Hi during the camp session of June 21 – June 28, 2015.
MEDICAL CONSENT
(I)(We), the undersigned parent/guardian of ______, a minor, do hereby authorize Camp O-Ki-Hi Adult Staff Members as agent(s) for the undersigned to consent to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of, any physician and surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any hospital whether such diagnosis or treatment is rendered at the office of said physician or at said hospital.
It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which aforementioned physician in the exercise of his/her best judgment may deem advisable.
This authorization is given pursuant to provisions of Section 25.8 of the Civil Code of California. Authorization shall remain effective until June 28, 2015 unless sooner revoked.
(I)(We) hereby authorize any hospital which has provided treatment to the above named minor pursuant to the provisions of Section 25.8 of the Civil Code of California to surrender physical custody of such minor to (my) (our) above-named agent(s) upon the completion of treatment. This authorization is given pursuant to Section 1283 of the Health and Safety Code of California.
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Signature of Parent/Guardian Date
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Parent/Guardian Name (please print)
PG & PG-13 MOVIE PERMISSION
We may continue our tradition of a “Movie Night” evening program activity on one evening during our camp session. Movies will be chosen by Camp Management and will be rated G, PG or PG-13.
This form must be signed to allow your child to view movies which may be rated PG or PG-13. An adult staff member will be present while the movie is being shown. Alternative activities will be provided for those scouts who do not wish to view the movie or those without a signed permission slip.
Yes, it’s OK for my child to watch PG or PG-13 rated movies at Camp O-Ki-Hi.
I, the undersigned parent or legal guardian of ______, a minor, give consent for him/her to view movies rated PG or PG-13 while attending Camp O-Ki-Hi 2015.
No, I don’t want my child ______
to watch PG or PG-13 rated movies at Camp O-Ki-Hi.
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Parent/Guardian Signature Date
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Parent/Guardian Name (please print)
]Please note: Some of the C.O.P.E. events will be available to ALL scouts as an evening acitivity. Scouts do not need to be registered in the C.O.P.E. class to participate; however, the permission slip below must be returned.
I understand that participation in the climbing/rappelling activities offered at Camp O-Ki-Hi involve a certain degree of risk that could result in injury or death. In consideration of the benefits to be derived and after carefully considering the risk involved, and in view of the fact that the Boy Scouts of America is an organization in which membership is voluntary, and having full confidence that precautions will be taken to ensure the safety and well-being of my child, I give my consent for my child, ______to participate in Project C.O.P.E.and Climbing activities during Camp O-Ki-Hi summer session of 2015.
In case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the physician selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child.
]THIS FORM MUST HAVE THE SIGNATURES OF BOTH PARENTS/GUARDIANS
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Signature Signature
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Date Date
I, the undersigned parent or legal guardian of ______, a minor, do hereby authorize Camp O-Ki-Hi 2015 summer camp shooting instructors to furnish approved firearms and/or archery equipment to the minor named herein for the purpose of instruction in the safe handling and shooting of firearms, target shooting and related activities, in accordance with California Penal Code Section 12552.
This authorization will remain in effect for said minor while my child is participating in any program or activity related to firearms and/or archery at Camp O-Ki-Hi, unless revoked in writing by the undersigned and said revocation personally delivered to Camp O-Ki-Hi.
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Parent/guardian signature Date
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Parent/guardian name (please print)
]Please check off or circle, in ink, any or all items you DO NOT want your Scout to use:
BB Gun Air Rifle .22 Rifle Black Powder Rifle Archery Equipment