I authorize the camp director or other camp personnel to continue this medication as per instructions. In the event of an injury, illness, or requiring the attention of medical personnel, I agree, to permit transportation in private or public vehicles. I/We also give permission under such circumstances to the medical personnel, selected by Merom Camp and Retreat Center personnel and/or volunteer staff, to order x-rays, routine tests, or treatment.

In the event I cannot be reached in an emergency, I hereby give permission to the physician or other healthcare personnel selected by such camp personnel to hospitalize, secure proper treatment for and to order injection and/or anesthesia and/or surgery. I also give permission for my child to be given the following medication as needed: Aspirin, Tylenol, ibuprofen, decongestant, antihistamine, Pepto Bismol, any routine over-the-counter medication. I am aware that my personal insurance is primary and the Insurance Board coverage is secondary.