Summer Camp Authorization Form

Please complete the form below to finish enrolling your child/children in Summer Camp at Gilcrease Museum.

If you have questions, please contact Angie Williams, Education and Programs Specialist, at angie-williams@utulsa.edu or 918-596-2786.

Parent/Guardian Name*
First Last
Child Name*
First Last
Second Child Name
First Last
Third Child Name
First Last
Camp Participant Consent*
I agree.
I have full authority to and do voluntarily give permission for Minor to participate in the Gilcrease Museum Summer Camp (“Camp”), to be held at Gilcrease Museum (including its indoor and outdoor spaces) and the adjacent Stuart Park. I understand that participation in Camp activities can expose Minor to the risk of bodily harm and injury or damage to person or property. Acknowledging that such risks exist, I voluntarily assume all risks of loss, damage, or injury that may be sustained through my child's participation in summer camp at Gilcrease Museum. In consideration for Minor’s participation in the Camp, I for and on behalf of Minor, myself, my and Minor’s personal representatives, heirs, assigns and next-of-kin, hereby release, waive, forever discharge and covenant not to sue Gilcrease Museum, its officers, members, employees, volunteers, agents and representatives for any and all loss, damages, claim, demand, action or right of action, arising from or by reason of any injury, loss or damage to persons or property resulting or to result from participation in the Camp, including if caused by negligence. This contains the entire agreement between the parties hereto and all terms are contractual and not a mere recital. I am at least eighteen years of age and sign this Release of Liability voluntarily.
Signed*
First Last
Date*
MM slash DD slash YYYY
Medical Treatment Consent*
I agree.
I authorize Gilcrease Museum and its agents, representatives and employees to in connection with any Camp activities to administer routine preventative care or treatment to my child, including but not limited to: sunscreen, insect repellent, Band-Aids, antibiotic cream, and ice packs. I additionally authorize Gilcrease Museum and its agents, representatives and employees to seek and secure emergency medical transportation and treatment for my child while my child is in attendance at the Camp. I agree that I am responsible for any and all costs associated with the transportation and treatment. I certify that if my child has any special medical considerations, including food or other allergies, I have communicated those in writing to the Camp supervisor. If my child is taken to a hospital for treatment, the hospital has my authorization to provide treatment that a physician deems necessary for the well-being of my child. I understand that the museum’s staff will make every effort to notify me of an emergency immediately.
Signed*
First Last
Date*
MM slash DD slash YYYY
Photo Release Consent
I agree.
I authorize Gilcrease Museum, and anyone Gilcrease Museum may designate, to photograph images (“Images”) of my child while participating in Camp activities. I hereby agree that Gilcrease Museum will have the right to copy, edit, and publish those Images, including for promotional purposes. Name and biographical information will not be used. I understand that neither I nor my child will receive any royalties or other payment in connection with use of the Images or for granting this authorization.
Signed*
First Last
Date*
MM slash DD slash YYYY

Gilcrease Museum is temporarily closed for construction.

Gilcrease Museum

The World’s Largest Collection of Art and Artifacts of the American West

Summer Camp Authorization Form