Fairview Lake YMCA Camps Camper Release Form

Fairview Lake YMCA Camps assumes responsibility for the welfare and safety of all our campers. We require written permission for campers to be released to adults. By filling out this form, you are authorizing campers to be released to all of the listed parties below. This form will be used for departure days, visiting days or any other time a camper leaves Fairview Lake YMCA Camps during the summer. Electronic Signature/Authorization is required at the bottom of the form. Thank you for your cooperation.

PHOTO ID IS REQUIRED FOR CAMPER RELEASE.
BE SURE THAT ANYONE WHO IS PICKING UP
YOUR CAMPER HAS PHOTO ID WITH THEM.

Why do I need to provide my date of birth?

The safety of the children who use our facility has always been a top priority of Fairview Lake YMCA Camps. With this commitment in mind, our facility now uses the Raptor system to scan driver's licenses and state-issued IDs. To expedite this process, we ask you to provide your birthday, which will allow our staff to perform a pre-check before you arrive at camp. All visitors must still provide a driver's license or state-issued ID.

What is Raptor?

Technology has now evolved that provides instant screenings for registered sex offenders in all 50 states. Raptor, a leading web-based platform identifies unwanted visitors instantly by scanning driver’s licenses and state-issued ID’s and keeps unwanted guests from entering our YMCA. If a potential threat is identified, the Raptor system will send an instant alert to designated management staff. If necessary, law enforcement will be notified. Learn more about Raptor.

Please Note: Any changes to this form must be made in writing!


 

Child/ren's Name (only one form needed per family)
Name of Person Completing Form
Email Address

Parent/Guardian Information

Please include yourself and your child's additional parent/guardian. 
Parent/Guardian 1: 
Legal Name (First)
Legal Name (Last)
Date of Birth (mm/dd/yyyy)
Relationship to camper
Parent/Guardian 2:
Legal Name (First)
Legal Name (Last)
Date of Birth (mm/dd/yyyy) - required
Relationship to camper

Other Authorized Permission

PLEASE INCLUDE FULL LEGAL NAME AND DATE OF BIRTH FOR EVERYONE LISTED BELOW. 

The safety of the children who use our facility has always been a top priority of Fairview Lake YMCA Camps. With this commitment in mind, our facility now uses the Raptor system to scan driver's licenses and state-issued IDs. To expedite this process, we ask you to provide your birthday, which will allow our staff to perform a pre-check before you arrive at camp. All visitors must still provide a driver's license or state-issued ID.

Other Authorized Person 1:
Legal Name (First)
Legal Name (Last)
Date of Birth (mm/dd/yyyy) - required
Relationship to camper
Other Authorized Person 2:
Legal Name (First)
Legal Name (Last)
Date of Birth (mm/dd/yyyy) - required
Relationship to camper
Other Authorized Person 3:
Legal Name (First)
Legal Name (Last)
Date of Birth (mm/dd/yyyy) - required
Relationship to camper
Other Authorized Person 4:
Legal Name (First)
Legal Name (Last)
Date of Birth (mm/dd/yyyy) - required
Relationship to camper

By checking the box below, you authorize Fairview Lake YMCA Camps to release your child/ren to the individuals listed above, as long as they provide Photo ID.


UNAUTHORIZED PERMISSION

PLEASE USE THIS AREA ONLY IF A COURT ORDER EXISTS REGARDING YOUR CHILD'S CUSTODY.

If a court order relating to your child's custody or release exists, a copy must be provided to the camp office. You may email a copy to Michele Scabet or FAX (973-383-6386) a copy to our office. All custody paperwork will be kept confidential. 

Name (First, Last)
Name (First, Last)
Name (First, Last)

Electronic Signature/Authorization 

Today's Date (i.e. 02/18/2018)
Please enter "I AGREE" in the box as your electronic signature assuring that you agree to the above policy.

Any questions in regards to registration please contact Fairview Lake: call 800 686 1166 or email fairviewlake@metroymcas.org


 

Before submitting this form, please click on the link below to move the contents of box "A" into box "B" leaving the first box empty.

A: B: Click to Move


 

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