Please use full name of organization/group.
Express Assumption of Risk Associated with Ropes Challenge Course, Archery Tag, Climbing Wall, Zip Line, River Tubing, Canoeing, Mountain Boarding, Black Hole, Laser Tag, Shooting Sports including target archery, air rifles, tomahawk throwing, laser tag), and other related camp activities.
I, the above listed participant and parent/guardian if the participant is under 18, do hereby affirm and acknowledge that I am fully informed of the inherent hazards and risks associated with the above activities and other camp related activities, the transportation of equipment related to the activities, and travelling to and from activity sites in which I am about to engage. Inherent hazards and risks include but are not limited to:
- Risk of injury from the activity and equipment utilized is significant including the potential for permanent disability and death.
- Falling, causing broken bones, severe injuries to the head, neck and back which may result in severe impairment or even death.
- Changes in terrain, ground surfaces, rocks, stumps, debris, fences, posts, trees, other persons, and other natural and man-made hazards related to the execution of the activity.
- Exposure to outdoor elements, including but not limited to inclement weather, thunder and lighting, severe and or varied wind, temperature and other weather conditions.
- Personal injuries such as muscle strains or sprains because of unfamiliar movement or lack of proper spotting by a co-participant.
- Injuries from rope burns from the ropes or cables traveling through your hands. Participants can fall against the rope or other objects while on the challenge course. Participants may fall to the ground from heights of varying distances.
- Participants may experience and confront several types of fear or trauma especially on the challenge course. It is also possible that some participants might suffer mental anguish or trauma from the experience or their injuries.
- Possible malfunction of my own or others’ equipment related to the activity.
- My own negligence and/or the negligence of other participants.
- Heat related injuries and illness including but not limited to heat exhaustion, heat stroke, sunburn, hypothermia and dehydration.
- Attack by or encounter with insects, reptiles, and/or animals.
- Accidents or illness occurring in remote places where there are no available medical facilities.
- Fatigue chill, and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.
- My sense of balance, physical coordination, and ability to follow instructions.
- Drowning, cuts from Zebra Mussels in the river.
*I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death. Release of Liability, Waiver of Claims and Indemnity Agreement.
In consideration for being permitted to participate in activities at Camp Victory, I hereby agree, acknowledge and appreciate that:
- I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as releasees: Camp Victory Ministries, its employees, contractors, members, officers, affiliates and other agents.
- To release the releasees, their officers, directors, employees, representatives, agents, and volunteers from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releasees or otherwise. By executing this document, I agree to hold the releasees harmless and indemnify them in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of engaging in the above activities.
- By entering into this Agreement, I am not relying on any oral or written representation or statements made by the releasees, other than what is set forth in this Agreement.
- This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms shall be enforceable.
- PHOTO RELEASE Photographs and videos are routinely taken at events. I release the use of any images taken at this event for the purposes of photographing, video recording or streaming the event and promoting Camp Victory. With my signature below, I agree that images that are taken at this event by or on behalf of the event organizer may be used without compensation or additional permission.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.