Camp Caleb Medical Release Form

In case of emergency, I hereby give permission to the physician selected by the Camp Caleb supervising staff member to hospitalize, secure proper treatment for, order injection or anesthetic for, or approve surgery for my camper as named on their registration form. I also certify that my camper is in good physical condition and is fit to participate in any activity other than those listed in "restricted" on the registration form. I also certify that my child has no communicable diseases.

Name of Camper: __________________________________

Name of Parent or Legal Guardian: __________________________________

Signature of Parent or Legal Guardian: __________________________________