2020 Father-Son Campout Registration
FATHER/MALE FAMILY MEMBER INFORMATION
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CHILD(REN) INFORMATION
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MEDICAL INSURANCE INSURANCE

EMERGENCY TREATMENT STATEMENT

The above information is correct so far as I know and the person herein described has permission to engage in all prescribed camp activities except if noted above.   If my emergency contact cannot be reached  in an emergency I hereby give permission to the physician selected by the Camp Whispering Pines Director to hospitalize, secure proper treatment for, and to order injections, anesthesia or surgery for the above named participants.  I also agree to not hold Camp Whispering Pines Baptist Camp, its staff, residents, or any party to the Mobile Baptist Association legally responsible for any injury that may occur while on Camp property.  I also understand that me and my child(ren) may be taking part in camp activities such as hiking, ropes course and camping. I give permission for participation in these activities.  I also give permission to Camp Whispering Pines to photograph me and my child(ren) for promotional reasons only.  I understand that I am responsible for expenses incurred by sickness or injury not covered by camp insurance.

Parent/Guardian Signature

7740 Union Street

Citronelle, AL 36522

Office:  251.866.7868

office@campwhisperingpines.com

©2020 by Camp Whispering Pines.

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