Special Diet Notification

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In order to allow us all to plan appropriately, please complete this form at least two weeks prior to the when you will be attending camp.

Participant's First Name *

Participant's Last Name *

What is your pack number? (If staff, please write staff.) *

What week(s) will you be attending camp? *

Week 1 (June 25 - June 30)

Week 2 (July 2 - July 7th)

Week 3 (July 9 - July 14)

Week 4 (July 16 - July 21)

Week 5 (July 23 - July 28)

Required

Name of Parent/Guardian *

Contact Phone number *

Contact Email *

Please identify and describe dietary restrictions below: *

List all omitted foods: *

List possible substitutes: *

In order for us to better plan, please let us know your plan for your or your child's dietary needs. *

I plan on bringing all necessary food replacements. I will keep in mind that refrigeration space is limited and will pack in a compact manner.

I would like to talk to the cook about possible meal replacements that the camp can provide.

If you have any additional questions or concerns regarding dietary restrictions not included in this form, please explain below.

As the parent/guardian, please click below indicating that you acknowledge the following:

1. It is the camp's expectation that by sending your child to camp, he or she or the leader/parent has the necessary knowledge of their diet and can manage their food choices.

2. Camp cannot guarantee an allergen free environment. Careful considering needs to be taken for campers with severe allergies, particularly those susceptible to airborne transmission.

3. If your child has a severe allergy or dietary restriction, please contact the camp director to discuss if camp is properly equipped to manage your child's needs.

4. The food is prepared in an area with milk, eggs, tree nuts, sesame, wheat, soy, fish so cross contamination may occur.

Acknowledged

As the parent/guardian, please click below indicating that you acknowledge the following:

1. In Consideration of the Camper’s participation at camp, the Camper and Parent/Guardian jointly and severally release, forever discharge, hold harmless, and covenant not to sue any of their related or affiliated entities (the “Minsi Trails Council Parties”) with respect to any injury, loss, or damage, to person or property associated with participation in any Minsi Trails Council programs, whether arising from negligence or otherwise (the “Claims”).

2. The Camper and the Parent/Guardian jointly and severally indemnify, defend, and hold harmless the Minsi Trails Council Parties from and against the Claims.

3. The release and indemnity set forth herein shall be unconditional, absolute, and interpreted to the fullest and broadest release and indemnity permitted by law.

4. Upon arrival at camp and prior to their first meal eaten, it is the Camper's and Parent/Guardian's responsibility to identify themselves to our kitchen staff; then cooperate in helping us meet their need(s).

Acknowledged

By typing your name in this field, you are e-signing the information provided is correct on the form. Signature (if 18+) or Parent/Guardian Signature *

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