Medical Information
Camper medical information. Medical information will only be viewed by medical staff and the staff caring for your child. ITYS will keep this information confidential.
Allergies and Medical Conditions
Please list all medical conditions, allergies, medication and treatment that the staff should be aware of for the proper care of your camper. This includes the use/need of an asthma inhaler, epipen, etc...
Additional Information of Camper
Please share any information about your child's emotional or mental health that will aid us in their care while at camp. If there are any issues at home or additional stresses your child is enduring, please list those.
Liability / Waiver
This information is required to be reviewed and by dating, checking the boxes, and placing your digital typed signature/name, you are acknowledging and consenting to these terms.
I/We give permission for the camp nurse/designee for medical care, to give my child/ward his/her medication as listed and instructed, pursuant to Indiana Code 16-36-1
I/We, as Parent(s)/Guardian(s) give permission for my child to participate in ANY field trip or special event, conducted by the State Police, an agency of the State of Indiana, that might require such child to be taken off the Indiana State Police Camp University or Camp premises.
If your camper has a serious injury or illness and we are unable to reach you, we need your permission for EMERGENCY treatment as recommended by the attending physician. I/We give permission for Emergency treatment if needed, and as a Parent(s)/Guardian(s), assume all responsibility for any cost as a result of sickness or injury.
If your camper has a serious injury or illness and we are unable to reach you, we need your permission for Surgery treatment as recommended by the attending physician. I/We give permission for Surgery treatment, if needed, and I/We, as Parent(s)/Guardian(s), assume all responsibility for any cost as a result of sickness or injury.
I/We, as Parent(s)/Guardian(s), give permission for the use of my/our child's photograph(s) in camp promotional publications.
I/We, as Parent(s)/Guardian(s), do hereby release the State of Indiana, the Indiana State Police, the Indiana Troopers Youth Services, Inc., and The American Legion, its agents and employees from all actions, damages, claims or demands which I/We, my heirs, executors, administrators, or designees may have against the above named agencies/personnel for all personal injuries known or unknown and injuries to property, real or personal, caused by, or arising out of the above described activities or participation. I/We, the Parent(s)/Guardian(s), the undersigned, have read this release and understand all its terms, we execute voluntarily and with full knowledge of its significance, pursuant to Indiana Code 16-36-1.
Payment Submitted by: The American Legion
If the below information is known, please fill accordingly
