informed letter of consent for transportation

INFORMED LETTER OF CONSENT

FOR TRANSPORTATION

CampersName(s):______________________________________________________________________Transportingfromandtolocations:_____________________________________________________________________________________Date(s)ofTransportation:_______________________________________________________________DearParent:RiversEdgeCampandRetreatCentrehasarrangedtransportationtoandfromcampactivitiesonyourbehalfforyourchild(ren).Whileeveryprecautionistakenforthesafetyandgoodhealth,someactivitiesincludingtransportationcarrywiththemtheinherentriskofpersonalinjury.Yourpermissionisrequiredtoprovidethistransportation.Pleasecarefullyreadthefollowinginformationandconsentform.Ifyouareinagreement,pleasesignthisandreturnittothechurch.

PERMISSION

Igivepermissionformychild/charge(_____________________________)tobetransportedinamotorvehicledrivenbytheindividualidentifiedtoaneventatthespecifiedlocationonthedateindicated.Iunderstandthatmychildisexpectedtofollowallapplicablelawsregardingridinginamotorvehicleandisexpectedtofollowthedirectionsprovidedbythedriverand/orotheradultvolunteers.Iunderstandthatparticipationintheidentifiedeventisnotarequirementforparticipationin(nameoforganization’s)activities.Ihaveread,understand,anddiscussedwithmychildthat:

(1) Theywillbetraveling inamotorvehicledrivenbyanadultandaccompaniedbyasecondadultandtheyaretoweartheirsafety-beltwhiletraveling;

(2) They are expected to respect each other, the vehicles they ride in, and the people theytravelwithduringthetrip;

(3) Ridinginamotorvehiclemayresultinpersonalinjuriesordeathfromwrecks,collisionsoractsbyriders,otherdrivers,orobjects;and

(4) Theyaretoremainintheirseatsandnotbedisruptivetothedriverofthevehicle.

Rivers Edge Camp and Retreat Centre P.O. Box 39, Cremona, AB, Canada T0M 0R0 403-637-2766 (office) 403-637-2765 (fax) www.riversedgecamp.org

Irecognizethatbyparticipatinginthisactivity,aswithanyactivityinvolvingmotorvehicletransportation,mychildmayriskpersonalinjuryorpermanentloss.IherebyattestandverifythatIhavebeenadvisedofthepotentialrisks,thatIhavefullknowledgeoftherisksinvolvedinthisactivity,andthatIassumeanyexpensesthatmaybeincurredintheeventofanaccident,illness,orotherincapacity,regardlessofwhetherIhaveauthorizedsuchexpenses.Student’sName________________________________DateofBirth___________________

Address_____________________________________________________________________

PhoneNumber______________________Parents’WorkNumber_____________________

FamilyDoctor________________________________PhoneNumber___________________

Incaseofanemergency,contact________________________________________________Iherebyconsenttotheparticipationofmy/ourchild(ren)inthissupervisedactivity.I/we,theparentsorguardiansnamedbelow,authorizetheDirectororoneoftheRiversEdgeCampandRetreatCentrePersonneltosignconsentformedicaltreatmentandtoauthorizeanyphysicianorhospitaltoprovidemedicalassessment,treatmentorproceduresfortheparticipantnamedabove.I/we,namedbelow,undertakeandagreetoindemnifyandholdblamelessRiversEdgeCampandRetreatCentre,itspersonnel,itsDirectorsandBoardfromandagainstanyloss,damageorinjurysufferedbytheparticipantasaresultofbeingpartoftheactivitiesoftheRiversEdgeCampandRetreatCentre,aswellasofanymedicaltreatmentauthorizedbythesupervisingindividualsrepresentingtheRiversEdgeCampandRetreatCentre.ThisconsentandauthorizationiseffectiveonlywhenparticipatinginortravelingtoeventsoftheRiversEdgeCampandRetreatCentre.Ihaveread,understoodandagreewithabove.Activity:__________________________________________________________________Parent/GuardianSignature__________________________________________________PrintedName_________________________________Date________________________