Shannon's Hope Camp Registration Form (with pages)

Shannon's Hope Camp

Step 1 of 5

Have you already enrolled in Stepping Stones Program? *

Unsure ? If your child has already participated in one of our programs, please select YES and continue with this form. If you select NO, and your child has not participated, please complete the following enrollment before continuing to register.

Your Name *

First

Last

Email *

Transportation

Does your child need transportation ?

Choose one of the following:

I consent for my child to ride in a bus provided by Coastal Bus Line to and from Shannon's Hope Camp

I agree

COVID 19 Waiver

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE.

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person to person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore unknowingly spread the disease. The exact methods of spread and contraction are unknown, and there is no known treatment, cure or vaccine for COVID-19. Evidence has shown that COVID-19 can cause serious potentially life-threatening illness and even death.
Bridges/Shannon's Hope Camp cannot prevent you or your child(ren) from becoming exposed to, contracting or spreading COVID-19 while participating , being on premises, or in transportation methods provided by collaborative organizations. It is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize Bridges services, and/or enter onto its premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19.
ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my child(ren) in order to utilize Bridges services and enter premises. These services are of such value to me and/or my child(ren) that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize Bridges’s services and premises in person.
WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Bridges its agents and employees, volunteers, board members , and other representatives /collaborating organizations in connection with exposure, infection and/or spread of COVID-19 related to utilizing Bridges services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages whether known or unknown, foreseen or unforeseen.

Policies & Consent for Participation

Please read over the information below and sign your name electronically if you give consent

I, the undersigned parent (or guardian) of the child named above (hereinafter referred to as “child”), give my consent for the child’s participation in Bridges programming.

EMERGENCY CARE RELEASE: I authorize, that in an emergency situation, Bridges personnel/school staff to call emergency services. In the event that I cannot be reached or be present, I hearby authorize Bridges personnel/school staff to execute any and all documents including any necessary releases in my behalf which might be required by any medical facility to perform any emergency care on account of an accident or illness sustained or incurred by the child while participating in Bridges’ programming. I further agree that in consideration of my child participation in Bridges’ programming, I will hold Bridges for End-of-Life personnel/school staff harmless from any action by me, my child, or family members on account of any injury or damage sustained or suffered by my child while attending Bridges’ programming, and hereby waive any right of legal action against Bridges for End-of-Life.

MANDATORY REPORTING: Bridges’ staff and volunteers will maintain all confidentiality when working with children. However, South Carolina law does require that any of us report suspected cases of abuse or neglect to ensure the safety of our community’s children. A report must happen if a volunteer or staff member has any reason to believe that a child’s physical or mental health has been, or may be, adversely affected by abuse or neglect. By signing below, you acknowledge you have read and agree to all items listed above.

Signature

Shannon's Hope Camper Registration

Emergency Contact Information

Medical Information

Transportation

Policies & Consent for Participation

Camp Pre-Evaluation