Health Care Camp Consent Form

Please complete this form prior to Health Career Camp.

Code of Conduct Agreement

The Health Careers Camp (Camp) is designed to be an educational function, and all plans are made with that objective.
Ortonville Area Health Services (OAHS) wants every attendee to have an enjoyable experience with every attention paid to education, safety and comfort. All attendees will be expected to conduct themselves in a manner best representing their local school district. In order that every- one may receive the maximum benefits from participation, the “Code of Conduct” must be followed at all times.
Note that attendance is not mandatory. By voluntarily participating, you agree to follow the official Camp rules and regulations or forfeit your personal rights to participate. By signing this “Code of Conduct” you are simply reaffirming your dedication to be the best possible student.
  1. I will, at all times, respect all public and private property, including the facility where I attend the Camp.
  2. I will, at all times, respect all individuals (other students and adults) while in attendance at the Camp. I will not use profanity of any kind while in attendance at the Camp.
  3. I will not use alcoholic beverages, tobacco products, or illicit drugs of any kind while in attendance at the Camp. I will not use drugs unless I have been ordered to take certain prescription medications by a licensed physician. If I am required to take medication, I will, at all times, have the orders of the physician on me.
  4. I will not leave the Camp without the express permission of the Camp Site Coordinator. Should I receive permission, I will leave a written notice of where I will be with the Camp Site Coordinator.
  5. My conduct shall be exemplary at all times while at the Camp.
  6. I will keep the Camp Project Coordinator informed of my whereabouts at all times.
  7. I will wear my Camp identification badge at all times while at the Camp.
  8. I will attend and be on time for all Camp sessions and activities.

Liability & Photo Waiver

In consideration of the student’s acceptance into and participation in the Camp, any and all claims that the student and/or the student’s parents, guardians, heirs, agents, representatives, successors or assigns might have against OAHS, its employees, contractors, grantees, sponsors, officials and volunteers, for any and all injury or illness which may directly or indirectly result from the student’s participation in this program are waived by signing below.
By signing below, OAHS is granted the non-exclusive and irrevocable rights and license to make, edit, and use pictures for publicity, news or ad- vertising; including print, video, broadcast media and the internet. OAHS is released from any and all claims of payment for performance rights, residuals or damages for libel, slander, invasion of privacy, or any claim based on the use of said material.

Parental/Guardian Notification

Due to the nature of this camp, students may be exposed to latex, finger stick blood sampling, and other elements of a basic physical exam. By signing below, the student’s parent/guardian acknowledges and accepts these possible risks.

Violation and Penalties

I agree that if, for any reason, I am in violation of any of the rules of the Camp, I may be sent home at my own expense. I understand that notification of the violation and the action taken will be sent to my parents or guardians.
It is within the spirit of being a proud and meaningful attendee of the Camp that I agree to these rules of conduct by signing my name on this registration form. By signing this registration form, my parent and/or guardian affirm that I am worthy to attend this Camp.

Translate »