Mustang Athletics Summer Camp Release Form
Authorization to Consent to Medical Treatment
In the event I cannot be contacted to give consent, I hereby authorize Central Arkansas Christian, Inc. and any employees and agent to provide emergency first aid treatment for my student.
Authorization of Administration of Medicine
I give my consent for my child to be administered the following non-prescription medication(s) by Central Arkansas Christian, Inc.
Parents must supply other medicine that may be required for the student. Such medication should be brought to the school in the original container properly labeled with the name of the student, identification of the medication, the dosage and the time to be administered. A Medicine Release Form (found on the Summer Camp Homepage) must be filled out for each medication.
Mustang Athletics Summer Camps Release
I understand and agree that my electronic signature releases the camp, CAC and any participating party from liability in the event of injury and/or treatment of an injury, illness, or medical problem. My electronic signature also authorizes the treatment of an injury or medical problem by trained medical personnel in the event of an emergency. I also understand that the camp/CAC will not carry insurance for any camper and that any costs incurred in the treatment of any injury or medical problem are the camper’s responsibility.
$115 per child
All checks & cash should be mailed to Lynn Brown at CAC’s North Little Rock Elementary campus. (ATTN: Lynn Brown | 6101 John F Kennedy Blvd, North Little Rock, AR 72116. You may also drop off your payment at the Secondary Campus front office in an envelope labeled with your student’s name and “Mustang Athletic Camp Payment.” All checks should be made out to CAC with the camp specified on the subject line.