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Southwestern Michigan College

Camps and Conferences Participant Information and Waiver Form

All SMC Camps and Conferences participants must complete this waiver and the Student Activity Center waiver prior to the beginning of camp. Each waiver is good for the current calendar year.

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Participant Information
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Parent-Guardian-Emergency Contact Information
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Medical-Health Information
Are there any medical issues that you want us to be aware of?
Please explain the nature of the issues and what we may need to do if an issue arises in the space provided above.
Do you have any food allergies?
Please provide details above on the food(s) that you are allergic to.
Do you need any accommodations in order to participate in SMC Camps and Conferences?
Please describe any special accommodations that are required in the space provided above.
Are there any prescription medicines that you will need to take while at camp?
Medicines
If needed, please include any special instructions or additional information regarding the prescription medicines listed above.
Waiver Information

Please read of the statements and initial after you have read them. Supporting documentation for each statement, if applicable, is linked in the right-hand column.

Questions-Comments
Please enter any additional information, comments or questions or may have in the above field.
Signatures

You agree that your electronic signature (hereafter referred to as "E-Signature") provided below is the legal equivalent of what your manual signature would be on a paper form of this Waiver. You are also consenting to be legally bound by this document. You further agree no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature on this waiver.

You will receive an electronic copy of this form delivered to the Participant email address you provided above immediately upon submission of this form.

On screen signatures do not work in Internet Explorer. Please use Firefox or Chrome.