RELEASE BY PARENTS OR GUARDIAN
KNOW ALL MEN BY THESE PRESENTS: WHEREBY my child has applied for the activity or encampment referred to above, In consideration of the permission extended to my child by the Civil Air Patrol/United States of America through its officers and agents to participate in said activity/encampment or activities/encampments, I do hereby for myself, my heirs, executors, and administrators release and forever discharge the Civil Air Patrol, Inc./United States of America, and all its officers, agents and employees acting official or otherwise, from any and all claims, demands, actions or causes of action, on account of the death or on account of any injury to my child which may occur as a result of the negligence of the Civil Air Patrol/United States of America, its agents or employees during said activity/encampment or activities/encampments or continuances thereof, as well as all ground and flight operations incident thereto. In addition, by my signature below, I certify the applicant:
1.Is my minor child or ward.
2.Has no history or injury or disease which might be affected by this activity except those previously noted in the Medical Information section of this form.
3.Will follow all rules, regulations, and directives as established by the Civil Air Patrol, Inc., activity project officer or encampment commander, or other staff members. If not following the above mentioned rules, regulations, and directives he/she may be sent home at the discretion of the project officer, encampment commander or activity directory at my expense.
However, in case of injury, disease or other illness, permission is hereby granted to treat the applicant as required, and if the applicant is released from the activity before recovery from said injury, disease, or illness, further treatment will be provided by myself.
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Witness for Father’s Signature |
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Father or Legal Guardian |
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Witness for Mother’s Signature |
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Mother or Legal Guardian |
Squadron Certification. (Squadron Commander’s signature is not necessary if the activity is approved in eServices or if it is a squadron activity.)
I certify that the above information is correct and that all requirements for attendance, as specified in National Headquarters Directives, will be completed by the required dates.
Group Certification. (Group Commander’s signature is not necessary if the activity is approved in eServices or if the activity is held within the group.)
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Group Commander (or designee) |
Wing Certification. (Wing Commander’s signature is not necessary if the activity is approved in eServices or if the activity is held within the wing.)
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Date |
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Wing Commander (or designee) |
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CAPF 60-81 Reverse |
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OPR/ROUTING: CP |