If the answer to the above question is "yes," please download and fill out our Medication Dosage Instruction form (the form can be downloaded from www.lsbconline.com).  Campers' medications and the Medication Dosage Instruction form should be placed in a clear plastic zip-top bag and presented to camp staff at check-in.  If more than one camper is attending per family, make sure medications are separated by camper.

I, as the parent or legal guardian of the registered camper who is currently under the age of 18, am aware of, recognize and acknowledge the risks involved in participating in camp activities and warrant or represent that my child is physically fit and capable of participating in these activities.  On behalf of my child, I hereby 1) waive, release and discharge Lake Springfield Baptist Camp, its officers, agents, employees and volunteers from any and all liability, damages, claims, demands, losses, or causes of action of any and every kind, including death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter accrue to my child arising out of camp activities or activities preliminary or subsequent thereto; b) indemnify and hold harmless the Camp, its officers, agents, employees and volunteers from and against any and all liabilities, damages, claims, demands, losses or causes of action made by other individuals or entities as a result of any of my child's involvement in or actions during camp; and c) assume full responsibility for the risk of bodily injury, death, disability, or property damage arising out of or related to the above described activities, whether caused by my child's negligence or otherwise.

In the event of accident, injury or illness involving my child, under any circumstances where camper is unable to consent or parent is not present, I hereby voluntarily authorize and consent to furnishing such medical care, attention and treatment by any hospital, physician, or dentist as such hospital, physician or dentist may deem necessary or advisable, including any anesthetic, medical or surgical diagnosis or procedure.  I authorize the camp manager or persons authorized by the camp manager to consent to such medical care and treatment.  I agree that a photocopy of this consent or a copy sent by facsimile may be accepted by any health care provider. I accept responsibility for any medical bills incurred as a result.

Parents/Guardians will verify prior to bringing a camper to Lake Springfield Baptist Camp that their camper is not experiencing any of the following COVID-19 symptoms:
• Temperature of 100.4 degrees or greater
• Cough
• Chills
• Shortness of breath or difficulty breathing
• New loss of taste or smell
• Muscle and body aches
• Fatigue
• Sore throat
• Headache
• Congestion or runny nose
• Nausea and/or vomiting
• Diarrhea
• Any other COVID-19 symptoms identified by the Centers for Disease Control(CDC) or IDPH.

If a camper is experiencing any of the above symptoms within 5 days prior to being checked in at camp, parent/guardian agrees that camper will not attend camp.  Parent/guardian should notify camp staff so that an alternate camp session may be chosen or a refund issued.

I acknowledge that the entrance to Lake Springfield Baptist Camp, 5878 Iron Bridge Road, Chatham, Illinois, is an easement granted to us by neighboring landowners. As such, those landowners have established a speed limit of 10 miles per hour on the lane to the camp. Additionally, the landowners have erected speed bumps and placed other traffic control devices on the lane. I acknowledge that I am aware of the speed limit and traffic control devices and will comply with such directives when entering and exiting the camp. In the event my child is dropped off or picked up by someone else, I agree to make that person(s) aware of these directives, as well.