1st Emergency Contact - Can't be the parent/guardian
2nd Emergency Contact
1st Child's Information
2nd Child's Information
3rd Child's Information
Camp Noah Agreement with Guardians
By checking the box below I permit my child to participate in Camp Noah activities & programs. Additioanally it confirms agreement with the above statements, that all information provided on this form is complete and accurate, and releases Camp Noah, Hartford City Mission (HCM) and all of HCM’s staff/volunteers of any liability.
During Camp Noah, your child may go on field trips to various sites within the state of Connecticut. These field trips will enhance your child's learning! All field trips will have an appropriate number of chaperones. Children will be transported in vehicles that have been certified by the State of Connecticut as a Camp Vehicle and/or on a school bus by a licensed school bus driver. If our trip is in walking distance we will walk together as a group.
By checking the box below you have my permission to transport my child in all the above methods. I release Camp Noah staff and/or volunteers from any liability.
Photo and Video Release
During the Camp Noah programming, I understand that my child may be photographed or recorded on video to be used for memorabilia and future program promotion.
By checking the box below, you have my permission to photograph or videotape my child for inclusion in newspapers or for reasons stated above, or to display samples of her/his work.