Participant's Information
Genesis Hopeful Haven Allergen Release Form
WAIVER AND RELEASE OF LIABILITY - Each person attending any GHH Camp or Activity, must complete a Liability Waiver & Release form
I (participant or guardian),
fully understand and acknowledge
that meals and snacks will be provided each day of camp.
ALLERGY AWARENESS NOTIFICATION: If you or minor participant have food allergies, please be aware that Genesis Hopeful Have does not guarantee an allergen-free environment. Recipes may contain peanuts, nuts, nut oils, egg, shellfish, dairy, gluten, soy, produce and other food allergens.
Please sign and print your name below if you are 18 years and older to release liability.
Signature:
Printed Name:
Date:
If the participant is a minor or not their own guardian, parent or guardian must sign below.
I hereby certify that I am the parent or guardian of the above -mentioned individual and I give consent without reservations to the foregoing contract on behalf of him or her and release liability.
Participant minor’s full name:
Parent/Guardian Full Name (Printed):
Parent/Guardian Signature:
Enter your email to receive a copy of your answers:
FOSTERING NEW BEGINNING
PARENT/GUARDIAN SIGNATURE:
FIELD TRIP: Real Life Camp (2650 Lakeshore Dr, Marianna, FL 32446)
Method of Transportation: Charter Bus - Do you agree for your child to be transported in a vehicle to each of these locations?
(To be signed by Parent/Guardian):
1, the Undersigned Parent/Guardian, Hereby Consent To My Child
Participating in Activity and Field Trips
Sponsored by Genesis Hopeful Haven
Date received and filed by GHH:
2025 - Medical Treatment Authorization Form
I,
,hereby grant
the authority to obtain medical treatment for the following child
The above care provider are authorized to:
Obtain medical log and treatment for the child as may be appropriate in any emergency circumstance, including administering medication, first aid and other appropriate health care.
List of current medication (Please list details):
Please list any accommodations your child may need:
certify that my child
does not require any prescription or
over-the-counter medication during their time at Real Life Camp. I understand that if my child's medical needs change, I will notify the camp staff accordingly.