Release Form

Please complete the additional releases and acknowledgements.

"*" indicates required fields

Participant Name*

First Last

Date of Birth*

Email*

Is the participant under the age of 18?*

Yes

Parent or Guardian's Name*

First Last

Minor's Name*

First Last

Minor's Date of Birth*

Media Release*

As parent/guardian, I give permission to the International ALERT Academy to use the aforementioned minor's name, likeness or voice in any electronic, digital or printed media.

Medical Release*

As parent/guardian, I give permission to the Quest medical staff to seek medical attention and/or administer medication to my child on my behalf, under my direction.

Emergency Plan Acknowledgement*

As parent/guardian, I acknowledge that I have received a copy of the Quest Emergency Plan via email, and am aware that it is publicly available on the parent page of the Quest website.

Floodplain Disclosure*

As parent/guardian, I am aware that portions of the camp property are located within a FEMA-designated 100-year floodplain. Affected areas do not include any buildings or living spaces.

This determination is based on publicly available floodplain mapping data from the Federal Emergency Management Agency (FEMA) and local county records for Upshur County, Texas. For more information, see the Quest Emergency Plan.

Media Release*

I give permission to the International ALERT Academy to use my name, likeness or voice in any electronic, digital or printed media.

Emergency Plan Acknowledgement*

I acknowledge that I have received a copy of the Quest Emergency Plan via email, and am aware that it is publicly available on the parent page of the Quest website.

Floodplain Disclosure*

I am aware that portions of the camp property are located within a FEMA-designated 100-year floodplain. Affected areas do not include any buildings or living spaces.

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