Demo Form

State of Texas, County of Travis-
KNOW ALL MEN BY THESE PRESENTS:

That I (we), the undersigned are the father, mother, or legal guardian of the above named minor, herein after referred to as "youth".

I (we) do hereby agree that youth may attend and participate in the activities of the camp under the supervision of the officials of the camp and will abide by the rules of the camp and sponsors. That I (we) do further agree to forever release, acquit, discharge and covenant to hold harmless the Hensel Camp, its successors and assigns, the Southwest Church of Christ and other participating congregations as sponsors of the camp, herein after known as "sponsor," of and from any and all actions, causes of action, claims, demands, costs, loss of services and compensation on account of or in any way growing out of any loss or injury that may be sustained by youth and also all claims or rights of action for damages while youth may hereafter have arising from youth's attendance at the camp including any and all claims for damage of injury arising from the negligence of the camp or any of its employees, agents, directors, and/or volunteers. We further promise to bind ourselves, jointly and severally, and repay to the said camp, its successors and assigns any sum of money that the camp may hereafter be compelled to pay to or on behalf of youth because of any accident or injury arising out of youth's attendance at the camp.

I (we) further acknowledge that the camp and sponsors will rely upon the Authorization, Release, and Indemnity Agreement in allowing youth to attend the camp.

In the event that an attendee becomes ill or is injured while at the camp I (we) authorize the camp nurse or an individual under the direction of the camp nurse to provide necessary care to my (our) youth. I (we) recognize that the care may include basic first aid, administration of medications (i.e. labeled prescription medications and appropriate over-the-counter medications including, but not limited to acetaminophen, ibuprofen, Pepto-Bismol) and more advanced care if necessary.

I (we) further authorize the camp nurse or designated individual to seek further medical treatment when and where appropriate and to release appropriate medical information regarding my (our) youth to individuals providing medical care or third party payers.

As the parent(s) or legal guardian(s), I (we) have provided to the camp nurse appropriate medical information including known allergies, medical history and currently prescribed medications and treatments.