Summer Camp Liability Waiver Form

Informed Consent Release and Express Assumption of Risk

I realize injuries can be a consequence of participation in this activity and no amount of reasonable supervision or use of facility will prevent injury. I appreciate the character of the risk involved and I voluntarily assume (on behalf of my child if participant is a minor) all risk of possible death, harm or injury. I understand and appreciate that such injury could also include, without limitation, serious or permanent injuries to all bodily organs and functions. I am aware of the risk of participation in this designated activity.

I have carefully considered how the possible consequences of injury may impact my child’s life, and I choose to accept the risk involved (and allow them, if minor child) to participate in the designated activity. In accepting this risk, I expressly and explicitly release, discharge and waive any and all responsibility of East Stroudsburg University, Pennsylvania’s State System of Education, the Commonwealth of Pennsylvania, and the employees, officials or agents of any and all of the forgoing, pursuant to, or pertaining or related to, arising from, in any manner, injuries to my child as a result of their participation in this activity. In case of injury as a result of my child's participation in this activity, I hereby give advance permission to obtain medical service on behalf of my child, including but not limited to, paramedic treatment, transportation by emergency vehicle to a medical facility and treatment by emergency physicians. All extraordinary measures are to be taken in regard to treatment and I shall assume all financial responsibility as to any treatment.

I verify that my child is covered by health insurance. If I do not have health insurance, I agree to be totally responsible for any and all health costs associated with any injury incurred by my child in participating in this activity.

Photo Release Form

As stated on the ESU website, ESU and its representatives on occasion take photographs for the university’s use in print and electronic publications. The statement on the website serves as public notice of the university’s intent to do so and as a release of permission to the university to use such images as it deems fit.

You attest that you are the parent/guardian of the minors named above, you are of legal age, and you have the legal authority to execute this release. You do hereby give East Stroudsburg University of Pennsylvania, their assigns, licensees, and legal representatives the right to use your child's photograph and audio and video recordings to publicize the university.