St. Xenia Camp Parental Consent Form

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This must be read and digitally signed by the camper's parent(s)/guardian(s) in order for the camper to be eligible to attend camp this year.

Email *

Full Name of Camper *

Please read the following section and sign below.

We, the parent(s) / guardian(s) of the camper listed above, do give our consent and approval of his/her participation in any and all activities at the St. Xenia Camp for the year 2022.

We, the undersigned, do hereby agree to indemnify and hold harmless the host communities, their directors, officers, coaches, advisors and agents, without regard to any negligence on their part, against any claim for damages, compensation or otherwise including all losses and expenses caused to or by our child while participating in any activities at the St. Xenia Camp.

Photographs of campers and activities are taken during the camp week and are used for camp promotion. I (we) give our consent and approval for photographs of our son/daughter to be used by St. Xenia Camp on the camp website and related camp promotions.

In order to preserve harmony in the camp, parents will be responsible for picking up any camper guilty of gross misconduct within 12 hours of notification.

Full Name of Parent/Guardian #1 *

Full Name of Parent/Guardian #2

Initial of Parent / Guardian #1 *

By initialing this document, you agree that this constitutes a legal signature of this document.

Date of Signature *

YYYY

Initial of Parent / Guardian #2

By initialing this document, you agree that this constitutes a legal signature of this document.

Date of Signature

YYYY

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