Summer/Spring Break Camp Release Statements
I hereby authorize the Port Townsend Marine Science Center Summer/Spring Break Camp staff to act according to their best judgment in the event of any emergency involving my child which requires medical attention. I understand that the Port Townsend Marine Science Center reserves the right to send my child home from camp if they show signs or symptoms of any communicable/contagious disease (including but not limited to the following: measles, chicken pox, conjunctivitis and prolonged fever, vomiting or diarrhea). I know of no mental or physical problems which may affect my child's ability to safely participate in the camp. I will be responsible for any medical or other charges in connection with his or her attendance at camp. I have read, understand, and agree with the conditions of this registration. This completed form may be photocopied for field trips.
Prescription Medication Statement:
I hereby give my permission to the Port Townsend Marine Science Center Summer/Spring Break Camp to administer prescription medication to my child. Medications must be provided by parents/guardians in a plastic baggie, in their original labelled containers, clearly marked with camper name and instructions. Except for controlled substances such as ritalin, my child entering Grades 6-12 may self-administer medications with explicit parental AND PTMSC permission. Younger campers may carry and self-administer asthma inhalers with written permission from parents. All other medications will be held and administered by staff. Parents/guardians should communicate clearly with camp staff regarding any special instructions for medication administration.
Over-the-counter medication Statement:
I hereby give my permission for the Port Townsend Marine Science Center Summer/Spring Break Camp to administer the following over-the-counter medication if the certified staff deems it necessary. Dosages will be administered according to directions on the bottle. No other medication will be given by the PTMSC staff unless directed by a physician or as provided by me and listed on the medical information sheet.
||hives, bites, stings
|Triple antibiotic ointment
I hereby give my permission to PTMSC to use my child’s photograph/video likeness on its World Wide Web site or in other official printed publications without further consideration, and I acknowledge PTMSC’s right to crop or treat the photo or video at its discretion. I also acknowledge that PTMSC may choose not to use my child’s photo or video at this time, but may do so at its own discretion at a later date. I further agree to indemnify and hold PTMSC and its photographers/videographers harmless from any claims.
I hereby give my permission for the Port Townsend Marine Science Center to transport my child in a Transit Van and/or bus to off-site field trip locations. Note: All van drivers are over the age of 25, have a clean driving record for five years and are trained and certified by the Jefferson Transit Community Van program. Personal vehicles may be used in case of an emergency.
The Port Townsend Marine Science Center Summer/Spring Break Camps have a staff of four adult instructors for every 32 campers. Each staff is CPR and First Aid certified. Campers may hike up to three miles in a day over slippery terrain. The staff carries an emergency only cell phone, but the group may at times be out of cell phone range. Swimming will only occur when a life guard is on duty. Any boating activities will be supervised by a certified company. Campers must display responsible behavior on this trip. I understand that the Port Townsend Marine Science Center reserves the right to send my child home from camp if they display unmanageable behavior.
I have read the above camper participation statements/releases and have initialed each box indicating my compliance in these situations. I further agree that the Port Townsend Marine Science Center shall not be held liable and waive and release any claim of personal injury of named participant. I hereby give permission for my child to participate in the Port Townsend Marine Science Center Summer/Spring Break Camp program.