Waivers:
A. Your signature below indicates your consent for Cope Environmental Center to use any photograph,
picture or likeness of your child for promotional purposes.
B. I hereby give my permission to Cope Environmental Center to seek medical treatment for my child
while attending camp. I also authorize staff to administer First Aid, or transport my child to a medical facility, if the need arises.
C. If a Cope Environmental Center staff member is to administer any prescription drugs to my child while
there, the prescription will be in the original bottle with the name of the medication, the dosage, and the frequency of administration & note with time of last dose.
D. My child’s health history is correct and complete as for as I know, and my child, as described, has permission to engage in all camp activities except as noted. If there is something not included on the form, please attach an explanation or contact CEC staff.
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