By checking this box I have read and agree to the terms of the Lancaster Science Factory Parental Release Statement:
Lancaster Science Factory Camp/Program Parental Release



Agreement:


I hereby grant permission for my child to participate in the enrolled camp or program at the Lancaster Science Factory as described. I understand the Lancaster Science Factory may deny enrollment or dismiss at any time any enrollee whom it considers not to be participating properly in the camp or program. I also understand that any of the camps or programs receiving an insufficient registration may be cancelled.


In the event of an emergency requiring immediate medical treatment, I understand that the staff of the Lancaster Science Factory will try to reach me by using the telephone numbers listed in this form. In the event that I cannot be reached, I authorize treatment by appropriate personnel to administer any prescribed medications to my child or any emergency care (i.e. Epipen for allergic reactions) as approved by Lancaster Science Factory staff. If such care is needed, I authorize the Lancaster Science Factory to make the decision to take my child to the nearest hospital (Lancaster General Hospital) in the event of extreme emergency.


We understand and accept the need for the Lancaster Science Factory to be fully informed as to the physical and mental health of the enrollee. Failure to disclose such essential information at the time of enrollment or upon the request of the Lancaster Science Factory can be cause for dismissal from camp or program. The Lancaster Science Factory pledges to respect the confidentiality of such information and to use it only for professional purposes.



Release Statement:


In consideration of the acceptance of the minor for enrollment in the Lancaster Science Factory camp or program, I hereby release and discharge the Lancaster Science Factory, its agents, employees and officers from claims, demands, actions, judgments and executions which the undersigned, as parent or guardian of the enrollee, ever had or now has, or may have, or which the undersigned’s heirs, executors, administrators, or assigns may have or claim to have against the Lancaster Science Factory, its successors or assigns, for all personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, the camper’s enrollment in the Lancaster Science Factory Summer camp or program.