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2008 Medical Release:

Please print completed form, be sure to sign the medical release statement below after printing.  Thanks.

 

Medical Release:  “In case of sickness or accident, Camp Witness has my authorization to obtain such medical attention as is deemed necessary for my child, if unable to communicate with me immediately.”

 

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Parent’s Signature

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For Camper 

Return this form with payment if paying by check.

Mailing Address

 

Camp Witness

HCR 62 Box 30B

Long Pine NE 69217

402 273 4352

Please send this form with camper if paying Online.

CLICK HERE to pay online after printing.