I/We the undersigned parent(s), desiring that my/our child shall have the opportunity to visit Northwestern Electric Cooperative, Inc., hereby consent to our child taking this trip. I/We further authorize and direct Northwestern Electric Cooperative, Inc., through its duly assigned youth coordinator during said camp to direct and supervise my/our child. I/We further request and authorize Northwestern Electric Cooperative, Inc., through said youth coordinator, to secure any medical or other emergency services they may, in their discretion, believe to be necessary for my/our child during this visit. I/we certify that I/we have answered the above questions as accurately as possible, and that all known medical information about this child has been listed accordingly and that I/we have read, understand and acknowledge that I/we are releasing NWEC from any and all claims, causes of action and liability which may arise as a result of said medical conditions listed or which should have been listed. I/We understand that this checkbox will act as a signature confirming the validity of all responses on this form, consenting to emergency care for the participant, and releasing NWEC from any liability as previously mentioned.
