I hereby give consent for my camper to attend Camp Endres at the CENTRAL OKLAHOMA CAMP & CONFERENCE CENTER and participate in all activities associated with camp and:
Liability Disclaimer: …Hold harmless Diabetes Solutions-OK, Inc. and Central Oklahoma Camp & Conference Center, its associates, its agents, volunteers and employees, from any and all liability of whatsoever nature and from injuries, sickness, or other damages suffered by us or camper during his or her participation with diabetes camp. I/We further authorize and grant to Diabetes Solutions-OK, Inc., its associates, its agents, volunteers and employees, the right to take pictures of said camper during his or her participation with diabetes camp, and use the same for the purpose of creating educational films, and brochures, including use in news releases, and/or other publications, and we release you from any liability therefore.
Medical Disclaimer: …Understand there will likely be changes made in my camper’s insulin doses and food intake in attempts to prevent unusually low or high blood sugars. It will be my responsibility to contact my camper’s physician, nurse, etc. for additional questions and/or any recommendations for changes in the diabetes treatment plan following the camp.
Authorization for Medical Treatment: …Acknowledge this health history is correct so far as I/we know and my camper has permission to engage in all prescribed camp activities except as noted by myself or our physician. In the event I cannot be reached in an EMERGENCY, I hereby authorize the physician selected by the camp medical director(s) to hospitalize, secure proper treatment for, and to order injection, anesthesia, blood and blood products, or surgery for my son/daughter.
Field Trip Permission: …Give permission for our camper to travel from Central Oklahoma Camp & Conference Center within a 30 mile radius for field trips as part of the Camp Endres experience. I realize transportation will be provided by the Putnam City School busses and campers and staff will travel as a group specifically arranged by Camp Endres.
I/We, the undersigned parents and/or legal guardian of above named camper, have read and understand the above statements concerning described liability disclaimer, medical disclaimer, and authorization for medical treatment.
As the participating camper, I have read the rules listed below and understand that it is my responsibility to follow these rules. If I choose not to, I will be dealt with appropriately by the staff.
1) I will RESPECT the grounds and facilities, my fellow campers and staff and their possessions.
2) I will be PREPARED for the routine daily activities as scheduled and will PARTICIPATE in these (this includes blood glucose monitoring, insulin dosing, meals and snacks, and program activities) according to my needs and abilities.
3) I will WORK hard at having a great time, meeting new friends and sharing my time and talents with others.
4) I realize that the use of recreational drugs, any form of tobacco including vapes and juuls, and alcohol or prescription meds not prescribed for me is NOT permitted.
5) I will NOT steal or take things that are not mine and I will report those who do.
6) I realize that if I do not follow the above stated rules, I may no longer be permitted to participate in ANY future camping programs under the sponsorship of Diabetes Solutions-OK, Inc.