If your camper requires medical treatment while at camp, your family's or camper's health insurance information will be used at the clinic or hospital.  Please provide that information below. 

This section helps our volunteer staff and medical personnel know about this camper's medical needs including:

• Any medications your camper will take during camp
• Over the counter medications allowed or not allowed to your camper
• Allergies, diet, nutrition, and vaccinations
• General health questions and any restrictions
• Social & Emotional Health

Allergy Information:

Meds:

Medical History

Social/Emotional Health:

As the parent or legal guardian of  participant ("Minor"), each of the undersigned gives his or her 

authorization and consent for Pueblo Presbytery (the "Church") and the Church's adult employees, agents, and volunteers (collectively with the Church, the "(Pueblo Presbytery Parties") to seek, authorize, and consent to such medical or dental care for Minor ("Treatment") as anyone or more of them may deem necessary or appropriate. Such Treatment (I) shall be provided upon the advice of and supervision by a physician, surgeon, dentist, or other medical practitioner licensed to practice under the laws of the state or jurisdiction in which such Treatment is sought, and (2) may include, without limitation, X -ray examination; anesthetic; medical, dental, or surgical diagnosis or treatment; and hospital care. Every effort will be made to contact one of the signers of this authorization before treatment is authorized whenever possible. This Authorization for Medical Treatment may be a photocopy and shall be as valid as an original copy. 

Each of the undersigned acknowledges and agrees that Pueblo Presbytery Parties shall not be legally or financially liable for any bill or expense incurred in, or any cause of action or claim arising from, the provision of any Treatment or the failure to provide or seek any Treatment. In consideration of Minor's participation in one or more events sponsored by the Church, each of the undersigned hereby agrees to indemnify, defend, and hold harmless Pueblo Presbytery Parties from and against any and all losses, damages, liabilities, or expenses (including, without limitation, reasonable attorneys' fees and other costs of defense) in connection with any and all actions, suits, claims, or demands that may be brought or instituted against any Pueblo Presbytery Party and arise out of or result from the provision of any Treatment or the failure to provide or seek any Treatment. This paragraph shall survive any termination or expiration of the Authorization for Medical Treatment, for any reason. 

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING IT. IT AFFECTS THE LEGAL RIGHTS OF YOU, THE STUDENT, AND OTHERS. 

I, the undersigned parent/legal guardian of the minor student identified above hereby give my permission for the student to participate in any program or event occurring under the direction and or supervision of Pueblo Presbytery; and to be transported to, from and during the Events in any vehicle designated by an employee, agent, or volunteer (an "Agent") of Pueblo Presbytery (the "Church") if needed. 

In consideration of the student being allowed to participate in the Program:

1.     I understand that the church and its volunteers will exercise their judgment in supervising the student and other participants in all sponsored activities and have a right to expect conduct of activities to be accomplished in a safe and careful manner. In spite of this care, it is always possible for the student to be injured or become ill during the activities. In consideration of sponsoring, organizing and supervising the activities during this time period as well as providing other services before, during and after the activities, I agree to defend, and hold harmless the Church and any of its Agents, employees or volunteers (collectively, "Pueblo Presbytery Parties") from and against any and all losses, damages, liabilities, or expenses that arise out of or result from the Student participating in the Program. 

2.     I understand and agree that the Student may be sent home at my expense if any Agent, employee or volunteer determines that the Student has: engaged in disruptive behavior, broken any rules or constitutes a threat to the safety or well being of any other participant at any time during any activity

Registration fees are strictly non-refundable after December 31, 2026.