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Medical Information

Is your camper in general good health and able to participate in all normal camp activities?
I attest that my child is up to date on all vaccinations and Tetanus shots. Please select all that apply.
Do you have health insurance?

Payment & Acknowledgements

Financial scholarships may be available if any of the following apply to your camper.
Select an option

Acknowledgements, Medical & Liability Waiver, Photo Release, etc.

In the event I cannot be reached in and emergency during the camp dates as shown on my form, I hereby give my permission to the physician or dentist selected by Promise Ranch Ministries to administer medical aid and required for illness proper treatment and/or order and injection, anesthesia, or surgery for my child as deemed necessary.  I also authorize the nurse/EMT on duty to administer medical aid as required for the illness or injury under a physician’s orders.  The signature of the parent or guardian below is intended to serve as a medical release.  This form may be copied and given to the counselor if there is information pertinent to the care of my child.  If there is a reason that you wish this information to stay confidential, please contact our Promise Ranch Office. I also give permission for purpose of medical transport to take my child off property of Promise Ranch, and release of medical records in case of illness or injury. The undersigned does hereby release, discharge, indemnify, and hold harmless Promise Ranch Ministries and property owners and all of their affiliated organizations and all of their officers, agents, contractors, directors, members, participants and employees/volunteers from all claims, demands, actions, judgments, and/or liabilities of whatsoever kind of nature, including any costs, attorneys’ fees, losses or expenses in connection therewith, in any way relative to, arising out of, or by reason of, my participation in, and attendance at, Promise Ranch Ministries and/or related facilities, including all claims or demands for death or injury to me or my child, or any damage to, or destruction of any of my or my child's property arising out of any accident or occurrence with, said attendance, participation and/or presence, whether negligent or otherwise. This waiver, Release and Indemnification is given in consideration of, and as a condition to, permitting the undersigned to participate in any Camp of Promise Ranch Ministries.  

For promotional or marketing purposes, Promise Ranch reserves the right to use any photographs, audio, and video footage of guests or campers participating in Promise Ranch Facilitated  events.  I also give permission for my child to be transported in a camp operated vehicles for approved offsite activities. 

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