I, the parent or guardian of the above camper(s), understand that completion of this form with my signature grants permission for the named camper to participate in a Camp Pitt program. I release Camp Pitt staff, faculty, officers, and management from any liability and shall not hold them responsible for any lost, stolen or misplaced personal property. Camp Pitt is permitted to use video, audio, and photographic materials of named camper(s), taken while participating in or attending a camp program, to promote and market Camp Pitt and its ministry.

I, the parent or guardian of the camper(s) named on this form, give my permission to the camp nurse and/or other authorized personnel at Camp Pitt to distribute over-the–counter remedies or medications for minor needs such as: headache, fever, minor pain, minor allergic reactions, upset stomach, minor injuries; and, to dispense prescription and over-the-counter medication designated and provided by the the parent/guardian or family physician. I, having the authority to consent for the minor’s health care, do hereby delegate my authority to consent to said minor’s care (named in this registration) to Camp Pitt. I grant permission for the caregiver to request and authorize any and all examinations, medical treatments, and/ or procedures to or for the benefit of the minor as may be deemed advisable or appropriate by any physician licensed to practice medicine. I understand however that every effort will be made to contact me in case of such emergency and if possible, before any such medical treatment is administered. Camp Pitt provides medical co-insurance for all participants. The family or individual medical policy will be primary. The camp's policy is secondary and will pay eligible costs as determined by the camp's insurance provider to the limit of the policy. I understand I am responsible for any medical cost that may occur on behalf of the camper.

I, the parent or guardian, understand that all registrations are 100% transferable. That parents/legal guardians must request a code from the Camp Pitt office ([email protected]) to transfer a registration to a new camper. And understand that cancellations due to a medical emergency, illness, or family emergency can receive full refunds upon request and approval.

I have read and agree with the Terms & Conditions in this online document, including the illness disclaimer, and I understand that Camp Pitt's disciplinary policy applies to my camper's participation in Camp Pitt's programs.